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, 郑慧玲, 贾红玲, 等. 近10年针刺治疗偏头痛机制研究进展. 针灸临床杂志, 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.	邓元江, 刘卫英, 刘宝莲. 偏三针治疗偏头痛疗效观察. 河北中医, 2001, 23(3): 205-206.
13.	刘克英, 刘秀梅, 马成福, 等. 针刺与药物治疗偏头痛临床疗效对比研究. 中国针灸, 2001, 21(9): 515-517.
14.	倪承浩. 开" 四关”治疗无先兆性偏头痛32例. 上海中医药大学学报, 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.	钟广伟, 李炜, 罗艳红, 等. 针刺肝胆经穴治疗偏头痛: 多中心随机对照研究. 中国针灸, 2009, 29(4): 259-263.
17.	谢菊英, 贺莉萍, 李志宏, 等. 针刺足少阳经经穴为主治疗偏头痛31例临床观察. 中医药导报, 2009, 15(4): 60-61.
18.	韩鹏, 胡新颖. 针刺治疗偏头痛的疗效及对TCD影响的临床研究. 针灸临床杂志, 2010, 26(9): 22-23.
19.	朱守莲, 李乐敬. 中西医结合治疗典型偏头痛患者的疗效观察. 中国卫生产业, 2011, 8(11): 71-73.
20.	林海波, 郁保生, 常小荣, 等. 针刺少阳经特定穴治疗偏头痛患者近期疗效及脑血流速度的临床观察. 中华中医药杂志, 2013, 28(3): 846-848.
21.	常小荣, 林海波, 刘密, 等. 针刺少阳经特定穴治疗偏头痛患者远期疗效的临床观察. 中华中医药杂志, 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, 栗刚. 针灸治疗偏头痛患者的效果及其对血清基质金属蛋白酶-2活性的影响. 辽宁中医杂志, 2015, 42(10): 1971-1973.
24.	苏慧媛, 李晶, 杜元灏. 调神疏肝针刺法治疗偏头痛35例疗效观察. 湖南中医杂志, 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. 针刺临床试验干预措施报告标准修订版: CONSORT声明的扩展. 中国循证医学杂志, 2010, 10(10): 1228-1239.
28.	张明妍, 张俊华, 杜亮, 等. 核心指标集研制标准: COS-STAD推荐. 中国循证医学杂志, 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, 郑慧玲, 贾红玲, 等. 近10年针刺治疗偏头痛机制研究进展. 针灸临床杂志, 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. 邓元江, 刘卫英, 刘宝莲. 偏三针治疗偏头痛疗效观察. 河北中医, 2001, 23(3): 205-206.
13. 刘克英, 刘秀梅, 马成福, 等. 针刺与药物治疗偏头痛临床疗效对比研究. 中国针灸, 2001, 21(9): 515-517.
14. 倪承浩. 开" 四关”治疗无先兆性偏头痛32例. 上海中医药大学学报, 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. 钟广伟, 李炜, 罗艳红, 等. 针刺肝胆经穴治疗偏头痛: 多中心随机对照研究. 中国针灸, 2009, 29(4): 259-263.
17. 谢菊英, 贺莉萍, 李志宏, 等. 针刺足少阳经经穴为主治疗偏头痛31例临床观察. 中医药导报, 2009, 15(4): 60-61.
18. 韩鹏, 胡新颖. 针刺治疗偏头痛的疗效及对TCD影响的临床研究. 针灸临床杂志, 2010, 26(9): 22-23.
19. 朱守莲, 李乐敬. 中西医结合治疗典型偏头痛患者的疗效观察. 中国卫生产业, 2011, 8(11): 71-73.
20. 林海波, 郁保生, 常小荣, 等. 针刺少阳经特定穴治疗偏头痛患者近期疗效及脑血流速度的临床观察. 中华中医药杂志, 2013, 28(3): 846-848.
21. 常小荣, 林海波, 刘密, 等. 针刺少阳经特定穴治疗偏头痛患者远期疗效的临床观察. 中华中医药杂志, 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, 栗刚. 针灸治疗偏头痛患者的效果及其对血清基质金属蛋白酶-2活性的影响. 辽宁中医杂志, 2015, 42(10): 1971-1973.
24. 苏慧媛, 李晶, 杜元灏. 调神疏肝针刺法治疗偏头痛35例疗效观察. 湖南中医杂志, 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. 针刺临床试验干预措施报告标准修订版: CONSORT声明的扩展. 中国循证医学杂志, 2010, 10(10): 1228-1239.
28. 张明妍, 张俊华, 杜亮, 等. 核心指标集研制标准: COS-STAD推荐. 中国循证医学杂志, 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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