Ginger for the treatment and prevention of migraine headaches: a systematic review and meta-analysis of randomised controlled trials.

IF 10.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Tiffany Atkins, Sam Manger, Loai Albarqouni
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引用次数: 0

Abstract

Objective: To determine the efficacy of ginger (either stand-alone or as an adjunct treatment) for the treatment and management of migraine headaches.

Methods: We searched PubMed, Embase, CINAHL, PsycINFO, Epistemonikos and Cochrane CENTRAL from inception to 26 March 2025 which was updated on 16 April 2026 and conducted a backwards and forwards citation search of included studies. We included randomised controlled trials (RCTs) that compared the effect of ginger (either stand-alone or as an adjunct) to placebo or usual active control (such as Depakine (valproic acid), amitriptyline or sumatriptan). Two authors independently screened articles, extracted data, assessed risk of bias using the Cochrane Risk of Bias 2 Tool (ROB-2) tool. Primary outcomes included headache severity or pain scores post-treatment, proportion of patients pain free or with pain relief post-treatment, frequency and duration of migraine attacks and migraine-associated symptoms. Random-effects meta-analyses were done and the certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.

Results: Eight RCTs involving 594 patients were included. For acute treatments, ginger with ketoprofen compared with placebo with ketoprofen may have little to no difference on headache severity at 2 hours post (mean difference (MD) 1.27 lower, 95% CI 1.46 lower to 1.08 lower; 1 study, 60 participants; low certainty evidence). It was very uncertain if ginger combined with feverfew versus placebo or ginger alone compared with sumatriptan improved proportions of those with pain relief, pain free or the mean headache severity at 2 hours post. For preventative treatment, ginger in addition to an active drug compared with the same active drug with or without placebo, may result in an important reduction in headache pain severity at 3 months (pooled MD -3.18, 95% CI -3.94 to -2.42; 2 studies, 183 participants; low certainty evidence). However, it was very uncertain if ginger combined with herbs compared with active drugs of both Depakine and amitriptyline lowered headache frequency, duration or headache severity at 3 months. The overall certainty of evidence for all outcome measures ranged from low to very low.

Conclusions: The volume of the existing evidence is limited and combined with either a low or very low certainty of evidence, it is currently too uncertain if ginger is effective either as an acute or preventative treatment. Therefore, additional acute and preventative trials are required to help raise the certainty of evidence.

Trial registration number: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251025768.

生姜治疗和预防偏头痛:随机对照试验的系统回顾和荟萃分析。
目的:确定生姜(单独或辅助治疗)治疗和管理偏头痛的疗效。方法:检索PubMed、Embase、CINAHL、PsycINFO、Epistemonikos和Cochrane CENTRAL自成立至2025年3月26日(更新于2026年4月16日)的文献,并对纳入的研究进行前后引文检索。我们纳入了随机对照试验(RCTs),比较生姜(单独或辅助)与安慰剂或通常的有效对照(如丙戊酸、阿米替林或舒马匹坦)的效果。两位作者独立筛选文章,提取数据,使用Cochrane风险偏倚2工具(rob2)评估偏倚风险。主要结局包括治疗后头痛严重程度或疼痛评分、治疗后无疼痛或疼痛缓解的患者比例、偏头痛发作的频率和持续时间以及偏头痛相关症状。进行随机效应荟萃分析,并使用分级建议评估、发展和评价(GRADE)方法评估证据的确定性。结果:纳入8项随机对照试验,共594例患者。对于急性治疗,生姜加酮洛芬与安慰剂加酮洛芬相比,2小时后头痛严重程度可能几乎没有差异(平均差异(MD)低1.27,95% CI低1.46至1.08;1项研究,60名参与者;低确定性证据)。生姜联合小白菊与安慰剂或生姜单独与舒马普坦相比,是否改善了疼痛缓解,疼痛消失或2小时后平均头痛严重程度的比例,这是非常不确定的。在预防治疗方面,生姜加活性药物与相同活性药物加安慰剂或不加安慰剂相比,可能在3个月时显著降低头痛严重程度(综合MD -3.18, 95% CI -3.94至-2.42;2项研究,183名受试者;低确定性证据)。然而,在3个月时,生姜与草药联合使用是否比Depakine和阿米替林的活性药物降低了头痛的频率、持续时间或头痛的严重程度,这是非常不确定的。所有结果测量的证据的总体确定性从低到非常低。结论:现有证据的数量有限,加上证据的确定性很低或很低,生姜作为一种急性治疗或预防治疗是否有效目前还太不确定。因此,需要额外的急性和预防性试验来帮助提高证据的确定性。试验注册号:https://www.crd.york.ac.uk/PROSPERO/view/CRD420251025768。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMJ Evidence-Based Medicine
BMJ Evidence-Based Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
8.90
自引率
3.40%
发文量
48
期刊介绍: BMJ Evidence-Based Medicine (BMJ EBM) publishes original evidence-based research, insights and opinions on what matters for health care. We focus on the tools, methods, and concepts that are basic and central to practising evidence-based medicine and deliver relevant, trustworthy and impactful evidence. BMJ EBM is a Plan S compliant Transformative Journal and adheres to the highest possible industry standards for editorial policies and publication ethics.
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