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Place · Level 3 · Condition
CGRP 现代模型 · 不只是头痛· 三剑客 B2 / Mg / CoQ10 + 现代单抗 · 触发因素 + 急救分层
synergy · 2
Sandor 2005 double-blind RCT (N=42) CoQ10 100 mg × 3/d × 3 mo cut migraine days ~50%; AHS 2012 lists it as Level B prevention. Slow onset (4-12 wk); together with Mg + B2 + fish oil forms atlas's 'nutritional quad' for migraine prophylaxis.
Peikert 1996 Cephalalgia (N=81) Mg citrate 600 mg/d × 12 wk cut migraine frequency 41.6% (placebo 15.8%). Mechanism: NMDA antagonism + cerebrovascular smooth muscle relaxation + raised CSD threshold. AHS 2012 Level B prevention.
regulates · 5
Modern migraine model: trigeminovascular activation → CGRP release → meningeal nociceptive afferents → pain + central sensitization. CGRP monoclonals (erenumab/fremanezumab/galcanezumab/eptinezumab) + small-molecule gepants have rewritten prevention + acute care since 2018.
Riboflavin is unexpectedly well-supported in migraine prophylaxis: the route is B2 to FAD to mitochondrial Complex II — it supplies the energy-production step. The effect size is modest but the number needed to treat is low, and it is cheap and safe.
Insomnia is a top-3 migraine trigger; reverse — migraine night waking + chronic pain → insomnia. Co-occurrence ~50%. CBT-I has indirect evidence for migraine frequency reduction. Treating one often treats both.
Estrogen withdrawal is the primary trigger for menstrual + perimenopausal migraine. Frequency + intensity rise in early perimenopause, often fall post-menopause. MHT type/timing materially affects attacks — transdermal E2 beats oral.
Dehydration gets blamed for migraine wholesale. It is on the trigger list, but the disorder runs on the CGRP neurovascular pathway, and drinking more water helps only marginally — treating it as the whole answer misses the tiered treatments that work.