以系統性文獻回顧分析，探討心理治療對藥物過度使用頭痛(MOH)之成效

Evidence-Based Medicine: Systematic Review on the Efect of Psychological Inter-ventions on Medication-Overuse Headache

目的：藥物過度使用頭痛(Medication Overuse Headache, MOH)帶來藥物副作用與心理健康風險。本文旨在透過實證醫學PICO框架，系統性回顧並統合分析心理治療對於MOH病人在臨床結果之效益。

方法：本文進行系統性文獻回顧，檢索 Embase、PubMed及ProQuest資料庫，比較心理治療與常規治療對MOH療效，並利用CASP及NOS進行品質評讀，採RevMan之隨機效果模式進行統合分析。

結果：共納入8篇文獻。心理治療與單純常規治療在頭痛頻率、藥量、失能程度等測驗上，未達顯著差異。然，在12個月的追蹤中，「心理結合常規治療」在降低止痛藥使用的效益上，優於「單純心理治療」。

結論：心理治療在MOH照護中的價值雖呈現在個別研究當中，但在統合分析中未達到一致的定論，仍有進一步探討的必要。

 

Objective:Medication-overuse headache (MOH) poses the risks of medication side effects and mental health concerns. This study applied the evidence-based PICO framework to conduct a systematic review and meta-analysis of the clinical benefits of psychologi-cal interventions for treating MOH.

Method:A systematic literature review was performed by searching the Embase, PubMed, and ProQuest databases for studies comparing the efficacy of psychological interventions with that of usual care for MOH. Study quality was appraised using the Critical Ap-praisal Skills Programme and Newcastle–Ottawa Scale, and a meta-analysis was per-formed using the random-efects model in RevMan.

Result: Eight studies were included. No signifcant diferences between psychological inter-ventions and usual care were discovered in outcomes such as headache frequency, medication use, and disability. However, at the 12-month follow-up, psychological intervention combined with usual care was more efective at reducing analgesic use than was psychological intervention alone.

Conclusion: Although individual studies have reported that psychotherapy has value within MOH care, the fndings of the current meta-analysis indicate that a consistent conclusion has not yet been reached on this topic, indicating a need for further investigation.