- 期刊
The Effectiveness of OnabotulinumtoxinA in Enhancing the Quality of Life of Patients with Migraine: Evidence-Based Medicine
以實證為導向－偏頭痛病患接受肉毒桿菌素治療，能否改善生活品質？
摘要
Chronic migraine is a disease that leads to considerable anxiety and pain in patients. Generally, most patients with chronic migraine resort to the use of painkillers and preventive medications to relieve pain, but often to no avail; the lack of effective treatment often causes patients with chronic migraine to feel helpless. Botulinum toxin is a type of neurotoxic protein that was originally used in medical cosmetic treatments, especially in the treatment of facial wrinkles. However, in recent years, botulinum toxin has been discovered to be potentially useful for alleviating migraine pain. According to the medical treatment guidelines published by the Taiwan Headache Society, botulinum toxin can be used for treating chronic migraine. Nevertheless, its use in Taiwan as a medication for treating chronic migraine remains rare. Thus, the cost-effectiveness of using botulinum toxin to treat migraine is a crucial clinic topic that is worth exploring. Applying the 5-step procedure of evidence-based medicine (EBM), the researchers entered certain keywords into several EBM databases to search for relevant studies that utilized a randomized controlled trial study design, from which clinical evidences were found and appraised. The articles selected were classified as Level 2 evidence and constituted the best existing evidence for the effectiveness of using botulinum toxin to treat migraine. Main research findings: After receiving botulinum toxin treatment, patients with chronic migraine have exhibited substantial improvements in their migraine frequency, quality of life, and depression level. Apart from EBM, the researchers also conducted a pilot study to further verify the effectiveness of botulinum toxin in treating migraine. The researchers hope that EBM and clinical findings of the current study can serve as a reference for medical personnel and aid them in providing high-quality care for patients with migraine.
並列摘要
慢性偏頭痛是一種令人憂心如薰、苦不可言的病症，常因此過度使用止痛藥和預防性藥物，但治療效果不彰而讓病患覺得生命似乎已經到了盡頭。肉毒桿菌素最初用在美容除皺，卻意外發現可以改善偏頭痛。台灣頭痛學會中治療準則指引建議，肉毒桿菌素可以治療慢性偏頭痛，但台灣地區仍不普遍。因此，肉毒桿菌素用於治療偏頭痛之成本效益是臨床重要的議題。本報告以實證過程5A，以關鍵字搜尋實證資料庫，搜尋到隨機分派控制試驗之文獻，並嚴格評讀其證據等級分類為Level 2，為現有的最佳證據。綜合研究結果：慢性偏頭痛病人經過肉毒桿菌素治療後，無論是在頭痛次數、生活品質或心理憂鬱均有改善。團隊成員更將結果落實於臨床應用，以前驅性試驗（pilot study）進行案例追蹤，以確認肉毒桿菌治療偏頭痛的有效性。依據此實證步驟過程與臨床應用結果，期望能提供醫護人員照護參考，並為病患健康福祉努力。