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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Targeted Review: Medications for Acute Migraine Treatment
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Targeted Review: Medications for Acute Migraine Treatment

机译：有针对性的审查：急性偏头痛治疗药物

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Objective: To assess the evidence base for drags used for acute treatment of episodic migraine (headache on < 14 days a month) in Canada. Methods: A detailed search strategy was employed to find relevant published clinical trials of drags used in Canada for the acute treatment of migraine in adults. Primarily meta-analyses and systematic reviews were included. Where these were not available for a drug or were out of date, individual clinical trial reports were utilized. Only double-blind randomized clinical trials with placebo or active drag controls were included in the analysis. Recommendations and levels of evidence were graded according to the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group, using a consensus group. Results: Eighteen acute migraine medications and two adjunctive medications were evaluated. Twelve acute medications received a strong recommendation with supporting high quality evidence for use in acute migraine therapy (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan, ASA, ibuprofen, naproxen sodium, diclofenac potassium, and acetaminophen). Four acute medications received a weak recommendation for use with low or moderate quality evidence (dihydroergotamine, ergotamine, codeine-containing combination analgesics, and tramadol-containing combination analgesics). Three of these medications were NOT recommended for routine use (ergotamine, and codeine- and tramadol-containing medications), and strong recommendations were made to avoid use of butorphanol and butalbital-containing medications. Both metoclopramide and domperidone received a strong recommendation for use with acute migraine attack medications where necessary. Conclusion: Our targeted review formulated recommendations for the available acute medications for migraine treatment according to the GRADE method. This should be helpful for practitioners who prescribe medications for acute migraine treatment.
机译：目的：评估在加拿大用于急性发作性偏头痛（每月头痛少于14天）的药物的证据基础。方法：采用详细的搜索策略来查找在加拿大用于成人偏头痛急性治疗的药物的相关已发表临床试验。主要包括荟萃分析和系统评价。如果这些药物不可用或已过期，则使用个别的临床试验报告。分析中仅包括使用安慰剂或活性药物对照的双盲随机临床试验。推荐和证据水平根据推荐评估，发展和评估（GRADE）工作组分级原则，使用共识小组进行分级。结果：评估了18种急性偏头痛药物和2种辅助药物。十二种急性药物得到了强烈推荐，并提供了用于急性偏头痛治疗的高质量证据（阿莫曲普坦，依曲曲坦，frovatriptan，纳拉曲普坦，利扎曲普坦，舒马曲坦，佐米曲普坦，ASA，布洛芬，萘普生钠，双氯芬酸钾和对乙酰氨基酚）。四种急性药物在质量低或中等的证据（二氢麦角胺，麦角胺，含可待因的联合镇痛药和曲马多的联合镇痛药）中使用效果不佳。不建议将其中三种药物常规使用（麦角胺，含可待因和曲马多的药物），并强烈建议避免使用丁烷醇和含丁巴比妥的药物。甲氧氯普胺和多潘立酮均强烈建议在必要时与急性偏头痛发作药物一起使用。结论：我们的针对性综述根据GRADE方法为偏头痛可用的急性药物制定了建议。这对于为急性偏头痛开药的医生应该有所帮助。

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