Efficacy of acupuncture for improving migraine symptoms and cerebral blood flow velocity: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LU Tingting ^1,2 ^# , YANG Xinmin ³ ^# , ZHANG Yanyan ⁴ , LI Erliang ⁵ , LU Cuncun ^1,2 , SHI Xiue ⁶ , LI Xiuxia ^2,7 ,  YANG Kehu ^1,2,6 ,  LIU Yali ⁸

1. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730030, P.R.China;
2. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, P.R.China;
3. Endoscopy Surgery Center, The PLA Fourth Fifty-one Hospital, Xi’an, 710054, P.R.China;
4. The Second Clinical Medical College of Lanzhou University, Lanzhou, 730000, P.R.China;
5. The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, P.R.China;
6. Gansu Provincial Rehabilitation Center Hospital, Gansu Evidence-Based Rehabilitation Medical Research Center, Lanzhou, 730000, P.R.China;
7. School of Public Health, Lanzhou University, Lanzhou, 730000, P.R.China;
8. Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, P.R.China;

Corresponding?author：

YANG Kehu, Email: kehuyangebm2006@126.com; LIU Yali, Email: lyl_201006@126.com

Keywords：

Acupuncture; Migraine; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.201901076

Video：

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Objectives To systematically review the efficacy of acupuncture for improving migraine symptoms and cerebral blood flow velocity.Methods CBM, CNKI, VIP, WanFang Data, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) on acupuncture for improving migraine symptoms and cerebral blood flow velocity from inception to September, 2017. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.Results A total of 17 RCTs involving 2 226 patients were included. The results of meta-analysis showed that, acupuncture could effectively reduce the frequency of migraine compared with placebo acupuncture (SMD=?0.97, 95%CI ?1.60 to ?0.34, P=0.002) and medicine group (SMD=?1.29, 95%CI ?1.85 to ?0.73, P<0.000 01). Acupuncture could shorten duration of headache compared with placebo acupuncture (SMD=?0.73, 95%CI ?1.25 to ?0.21, P=0.006) and medicine group (SMD=?0.88, 95%CI ?1.32 to ?0.45, P<0.000 1). Compared with placebo acupuncture, acupuncture could relieve headache intensity (SMD=?0.67, 95%CI ?1.15 to ?0.19, P=0.006). The acupuncture group was superior to the placebo acupuncture group (SMD=?10.99, 95%CI ?16.62 to ?5.36, P=0.000 1) and medicine group (SMD=?0.63, 95%CI ?0.87 to ?0.40, P<0.000 01) in improving the cerebral blood flow velocity.Conclusions Current evidence shows that acupuncture can effectively reduce frequency of migraine, shorten duration of migraine, relieve intensity of migraine and improve cerebral blood flow velocity. Due to limited quality of the included studies, more high quality studies are required to verify above conclusion.

Citation： LU Tingting, YANG Xinmin, ZHANG Yanyan, LI Erliang, LU Cuncun, SHI Xiue, LI Xiuxia, YANG Kehu, LIU Yali. Efficacy of acupuncture for improving migraine symptoms and cerebral blood flow velocity: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2019, 19(6): 665-672. doi: 10.7507/1672-2531.201901076 Copy

1.	Lipton RB, Stewart WF, Diamond S, et al. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache, 2001, 41(7): 646-657.
2.	Burch RC, Loder S, Loder E, et al. The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies. Headache, 2015, 55(1): 21-34.
3.	Schwedt TJ, Dodick DW. Advanced neuroimaging of migraine. Lancet Neurol, 2009, 8(6): 560-568.
4.	Tfelt-Hansen PC, Koehler PJ. History of the use of ergotamine and dihydroergotamine in migraine from 1906 and onward. Cephalalgia, 2008, 28(8): 877-886.
5.	Diener HC, Kronfeld K, Boewing G, et al. Efficacy of acupuncture for the prophylaxis of migraine: a multicentre randomised controlled clinical trial. Lancet Neurol, 2006, 5(4): 310-316.
6.	Wang LP, Zhang XZ, Guo J, et al. Efficacy of acupuncture for migraine prophylaxis: a single-blinded, double-dummy, randomized controlled trial. Pain, 2011, 152(8): 1864-1871.
7.	Linde K, Streng A, Jürgens S, et al. Acupuncture for patients with migraine: a randomized controlled trial. JAMA, 2005, 293(17): 2118-2125.
8.	朱永政, 鄭慧玲, 賈紅玲, 等. 近10年針刺治療偏頭痛機制研究進展. 針灸臨床雜志, 2017, 33(4): 77-80.
9.	Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia, 2013, 33(9): 629-808.
10.	Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5. 1.0. The Cochrane Collaboration, 2011. Available at: http://www.handbook.cochrane.org/.
11.	Allais G, De Lorenzo C, Quirico PE, et al. Acupuncture in the prophylactic treatment of migraine without aura: a comparison with flunarizine. Headache, 2002, 42(9): 855-861.
12.	鄧元江, 劉衛英, 劉寶蓮. 偏三針治療偏頭痛療效觀察. 河北中醫, 2001, 23(3): 205-206.
13.	劉克英, 劉秀梅, 馬成福, 等. 針刺與藥物治療偏頭痛臨床療效對比研究. 中國針灸, 2001, 21(9): 515-517.
14.	倪承浩. 開" 四關”治療無先兆性偏頭痛32例. 上海中醫藥大學學報, 2002, 16(4): 24-25.
15.	Zhou J, Li J, Li N, et al. Study on the attack control action of electro acupuncture on taiyang for migraine due to hyperac-tivity of liver yang randomied controled trial. World J Acu-moxi, 2008, 18(1): 10-21.
16.	鐘廣偉, 李煒, 羅艷紅, 等. 針刺肝膽經穴治療偏頭痛: 多中心隨機對照研究. 中國針灸, 2009, 29(4): 259-263.
17.	謝菊英, 賀莉萍, 李志宏, 等. 針刺足少陽經經穴為主治療偏頭痛31例臨床觀察. 中醫藥導報, 2009, 15(4): 60-61.
18.	韓鵬, 胡新穎. 針刺治療偏頭痛的療效及對TCD影響的臨床研究. 針灸臨床雜志, 2010, 26(9): 22-23.
19.	朱守蓮, 李樂敬. 中西醫結合治療典型偏頭痛患者的療效觀察. 中國衛生產業, 2011, 8(11): 71-73.
20.	林海波, 郁保生, 常小榮, 等. 針刺少陽經特定穴治療偏頭痛患者近期療效及腦血流速度的臨床觀察. 中華中醫藥雜志, 2013, 28(3): 846-848.
21.	常小榮, 林海波, 劉密, 等. 針刺少陽經特定穴治療偏頭痛患者遠期療效的臨床觀察. 中華中醫藥雜志, 2013, 28(4): 1139-1141.
22.	Wang Y, Xue CC, Helme R, et al. Acupuncture for frequent migraine: a randomized, patient/assessor blinded, controlled trial with one-year follow-up. Evid Based Complement Alternat Med, 2015, 2015: 920353.
23.	曾令虹, 栗剛. 針灸治療偏頭痛患者的效果及其對血清基質金屬蛋白酶-2活性的影響. 遼寧中醫雜志, 2015, 42(10): 1971-1973.
24.	蘇慧媛, 李晶, 杜元灝. 調神疏肝針刺法治療偏頭痛35例療效觀察. 湖南中醫雜志, 2016, 32(8): 102-103.
25.	Li Z, Zeng F, Yin T, et al. Acupuncture modulates the abnormal brainstem activity in migraine without aura patients. Neuroimage Clin, 2017, 15: 367-375.
26.	Gofshteyn JS, Stephenson DJ. Diagnosis and management of childhood headache. Curr Probl Pediatr Adolesc Health Care, 2016, 46(2): 36-51.
27.	Hugh M, Douglas GA, Richard H, 等. 針刺臨床試驗干預措施報告標準修訂版: CONSORT聲明的擴展. 中國循證醫學雜志, 2010, 10(10): 1228-1239.
28.	張明妍, 張俊華, 杜亮, 等. 核心指標集研制標準: COS-STAD推薦. 中國循證醫學雜志, 2018, 18(7): 753-757.

1. Lipton RB, Stewart WF, Diamond S, et al. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache, 2001, 41(7): 646-657.
2. Burch RC, Loder S, Loder E, et al. The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies. Headache, 2015, 55(1): 21-34.
3. Schwedt TJ, Dodick DW. Advanced neuroimaging of migraine. Lancet Neurol, 2009, 8(6): 560-568.
4. Tfelt-Hansen PC, Koehler PJ. History of the use of ergotamine and dihydroergotamine in migraine from 1906 and onward. Cephalalgia, 2008, 28(8): 877-886.
5. Diener HC, Kronfeld K, Boewing G, et al. Efficacy of acupuncture for the prophylaxis of migraine: a multicentre randomised controlled clinical trial. Lancet Neurol, 2006, 5(4): 310-316.
6. Wang LP, Zhang XZ, Guo J, et al. Efficacy of acupuncture for migraine prophylaxis: a single-blinded, double-dummy, randomized controlled trial. Pain, 2011, 152(8): 1864-1871.
7. Linde K, Streng A, Jürgens S, et al. Acupuncture for patients with migraine: a randomized controlled trial. JAMA, 2005, 293(17): 2118-2125.
8. 朱永政, 鄭慧玲, 賈紅玲, 等. 近10年針刺治療偏頭痛機制研究進展. 針灸臨床雜志, 2017, 33(4): 77-80.
9. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia, 2013, 33(9): 629-808.
10. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5. 1.0. The Cochrane Collaboration, 2011. Available at: http://www.handbook.cochrane.org/.
11. Allais G, De Lorenzo C, Quirico PE, et al. Acupuncture in the prophylactic treatment of migraine without aura: a comparison with flunarizine. Headache, 2002, 42(9): 855-861.
12. 鄧元江, 劉衛英, 劉寶蓮. 偏三針治療偏頭痛療效觀察. 河北中醫, 2001, 23(3): 205-206.
13. 劉克英, 劉秀梅, 馬成福, 等. 針刺與藥物治療偏頭痛臨床療效對比研究. 中國針灸, 2001, 21(9): 515-517.
14. 倪承浩. 開" 四關”治療無先兆性偏頭痛32例. 上海中醫藥大學學報, 2002, 16(4): 24-25.
15. Zhou J, Li J, Li N, et al. Study on the attack control action of electro acupuncture on taiyang for migraine due to hyperac-tivity of liver yang randomied controled trial. World J Acu-moxi, 2008, 18(1): 10-21.
16. 鐘廣偉, 李煒, 羅艷紅, 等. 針刺肝膽經穴治療偏頭痛: 多中心隨機對照研究. 中國針灸, 2009, 29(4): 259-263.
17. 謝菊英, 賀莉萍, 李志宏, 等. 針刺足少陽經經穴為主治療偏頭痛31例臨床觀察. 中醫藥導報, 2009, 15(4): 60-61.
18. 韓鵬, 胡新穎. 針刺治療偏頭痛的療效及對TCD影響的臨床研究. 針灸臨床雜志, 2010, 26(9): 22-23.
19. 朱守蓮, 李樂敬. 中西醫結合治療典型偏頭痛患者的療效觀察. 中國衛生產業, 2011, 8(11): 71-73.
20. 林海波, 郁保生, 常小榮, 等. 針刺少陽經特定穴治療偏頭痛患者近期療效及腦血流速度的臨床觀察. 中華中醫藥雜志, 2013, 28(3): 846-848.
21. 常小榮, 林海波, 劉密, 等. 針刺少陽經特定穴治療偏頭痛患者遠期療效的臨床觀察. 中華中醫藥雜志, 2013, 28(4): 1139-1141.
22. Wang Y, Xue CC, Helme R, et al. Acupuncture for frequent migraine: a randomized, patient/assessor blinded, controlled trial with one-year follow-up. Evid Based Complement Alternat Med, 2015, 2015: 920353.
23. 曾令虹, 栗剛. 針灸治療偏頭痛患者的效果及其對血清基質金屬蛋白酶-2活性的影響. 遼寧中醫雜志, 2015, 42(10): 1971-1973.
24. 蘇慧媛, 李晶, 杜元灝. 調神疏肝針刺法治療偏頭痛35例療效觀察. 湖南中醫雜志, 2016, 32(8): 102-103.
25. Li Z, Zeng F, Yin T, et al. Acupuncture modulates the abnormal brainstem activity in migraine without aura patients. Neuroimage Clin, 2017, 15: 367-375.
26. Gofshteyn JS, Stephenson DJ. Diagnosis and management of childhood headache. Curr Probl Pediatr Adolesc Health Care, 2016, 46(2): 36-51.
27. Hugh M, Douglas GA, Richard H, 等. 針刺臨床試驗干預措施報告標準修訂版: CONSORT聲明的擴展. 中國循證醫學雜志, 2010, 10(10): 1228-1239.
28. 張明妍, 張俊華, 杜亮, 等. 核心指標集研制標準: COS-STAD推薦. 中國循證醫學雜志, 2018, 18(7): 753-757.

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Efficacy of acupuncture for improving migraine symptoms and cerebral blood flow velocity: a meta-analysis

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