星状神经节阻滞治疗偏头痛的meta分析  

Meta-analysis of stellate ganglion block in treatment of migraine

作　　者：严宛鸿[1] 薛建军[1] 贾瑜 王世太[1] Yan Wanhong;Xue Jianjun;Jia Yu;Wang Shitai(Department of Anesthesiology,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China;School of Stomatology,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]甘肃省中医院麻醉科,兰州730050 [2]兰州大学口腔医学院,兰州730000

出　　处：《国际医药卫生导报》2023年第12期1629-1635,共7页International Medicine and Health Guidance News

基　　金：甘肃省科技计划资助项目-临床医学研究中心建设(20JR10RA435)。

摘　　要：目的系统评价星状神经节阻滞治疗偏头痛的临床有效性及安全性。方法计算机检索PubMed、Embase、Cochrane library、中国生物医学文献数据库、中国知网、维普数据库和万方数据库,纳入星状神经节阻滞治疗偏头痛的随机对照试验,检索时间截止至2022年9月。对纳入的研究采用Cochrane Handbook推荐的随机对照试验偏倚风险评估工具进行偏倚风险评估,并采用RevMan 5.4软件统计分析。结果共纳入26项研究2074例患者。结果显示:星状神经节阻滞组治疗偏头痛的有效率高于对照组[RR=1.21,95%CI(1.15,1.29),P<0.001]。与对照组相比,星状神经节阻滞治疗后头痛发作持续时间明显缩短[MD=-2.80,95%CI(-4.32,-1.28),P<0.001],头痛视觉模拟量表评分显著降低[MD=-1.02,95%CI(-1.35,-0.68),P<0.001],不良反应的发生率差异无统计学意义[RR=0.98,95%CI(0.46,2.09),P=0.95]。结论星状神经节阻滞治疗偏头痛在临床有效率、改善头痛发作持续时间和头痛程度方面有明显优势,且不增加其相关不良反应。Objective To systematically evaluate the clinical efficacy and safety of stellate ganglion block for migraine.Methods The PubMed,Embase,Cochrane Library,China Biology Medicine disc,China National Knowledge Infrastructure,China Science and Technology Journal Database,and WanFang Data were searched for randomized controlled trials on stellate ganglion block in the treatment of migraine from their establishment to September 2022.A risk of bias assessment tool recommended by the Cochrane Handbook was used to evaluate the inherent bias of the included studies.The data were statistically analyzed by the RevMan 5.4 software.Results In the final meta-analysis,26 studies with a total of 2074 patients were included.The results showed that the effective rate in treating migraine in the stellate ganglion block group was higher than that in the control group(RR=1.21,95%CI 1.15-1.29,P<0.001).The duration of headache attacks(MD=-2.80,95%CI-4.32-1.28,P<0.001)and the headache score of Visual Analogue Scale(MD=-1.02,95%CI-1.35-0.68,P<0.001)after the treatment in the stellate ganglion block group were lower than those in the control group.There was no statistical difference in the incidence of adverse reactions between the two groups(RR=0.98,95%CI 0.46-2.09,P=0.95).Conclusion The stellate ganglion block,an effective treatment for migraine,has obvious advantages in terms of reducing headache severity and improving headache duration,and does not increase its related adverse reactions.

关 键 词：偏头痛 星状神经节阻滞 META分析 

分 类 号：R747.2[医药卫生—神经病学与精神病学]