A Systematic Review and Meta-analysis of the Therapeutic Effect of Acupuncture on Migraine

Abstract

Background: Migraine is an intractable headache disorder, manifesting as periodic attacks. It is highly burdensome for patients and society. Acupuncture treatment can be beneficial as a supplementary and preventive therapy for migraine. Objectives: This systematic review and meta-analysis aimed to investigate the efficacy and safety of acupuncture for migraine, and to examine transcranial doppler changes after acupuncture. Methods: Reports, conference, and academic papers published before March 15, 2019 in databases including PubMed, Cochrane library, Embase, China National Knowledge Infrastructure, WANFANG Database, Chinese journal of Science and Technology, and China Biomedical were searched. Randomized controlled trials (RCTs) involving acupuncture, sham acupuncture, and medication in migraine were included. The Cochrane Collaboration software, RevMan 5.3, was used for data processing and migration risk analysis. Results: Twenty-eight RCTs were included. 15 RCTs included medication only, 10 RCTs included sham acupuncture only, and 3 RCTs included both. The study included 2874 patients, split into 3 groups: acupuncture treatment group (n = 1396), medication control group (n = 865), and sham acupuncture control group (n = 613). The results showed that treatment was more effective in the acupuncture group than in the sham acupuncture group (MD = 1.88, 95% CI [1.61, 2.20], P < 0.00001) and medication group (MD = 1.16, 95% CI [1.12, 1.21], P < 0.00001). Improvement in visual analog scale (VAS) score was greater in the acupuncture group than in the sham acupuncture group (MD = −1.00, 95% CI [-1.27,−0.46], P < 0.00001; MD = −0.59, 95% CI [-0.81,−0.38], P < 0.00001), and their adverse reaction rate was lower than that of the medication group (RR = 0.16, 95% CI [0.05, 0.52], P = 0.002). The improvement of intracranial blood flow velocity by acupuncture is better than that by medication, but the heterogeneity makes the result unreliable. Conclusions: Acupuncture reduced the frequency of migraine attacks, lowered VAS scores, and increased therapeutic efficiency compared with sham acupuncture. Ou et al. Meta-analysis of Acupuncture and Migraine Compared with medication, acupuncture showed higher effectiveness with less adverse reactions and improved intracranial blood circulation. However, owing to inter-study heterogeneity, a prospective, multicenter RCT with a large sample is required to verify these results.

Revealing the Neural Mechanism Underlying the Effects of Acupuncture on Migraine: A Systematic Review

“…Migraine is typically treated by various pharmacological or non-pharmacological therapies to relieve pain or prevent migraine attacks (Tfelt-Hansen, 2013 ). Although commonly used drugs, such as triptans, ergotamine preparations, and barbiturates, have achieved positive therapeutic effects in the treatment of migraine (Farri et al, 2012 ; Ou et al, 2020 ), side effects, such as weight gain, fatigue, sleep disturbance, gastrointestinal intolerance, and medication overuse headache, are common in patients with long-term use (Silberstein et al, 2012 ; Tfelt-Hansen, 2013 ). Hence, non-pharmacological therapies with less adverse effects that have a supplementary and preventive action are needed.…”

Efficacy of Acupuncture Treatment of Migraine Delivered by Senior or Junior Acupuncturists: Study Protocol for a Randomized Controlled Trial

“…Nowadays, results from accumulating high quality clinical evidences have supported the use of acupuncture for pain relief ( 27 – 30 ). In fact, this therapy is now widely accepted as a safe and efficacious strategy for migraine prevention, but the effect of verum over sham acupuncture is only moderate ( 13 , 31 ). This finding has been corroborated by results from several large-scale meta-analyses targeting acupuncture treatment for chronic pain conditions ( 32 – 34 ).…”

Comparison of Acupuncture and Sham Acupuncture in Migraine Treatment

“…In recent years, a series of scientific evaluations have been conducted on the efficacy and safety of acupuncture in treating migraine 10,26. Currently, increasingly more evidence supports the use of acupuncture in migraine patients 44,45. Although a number of previous systematic reviews have confirmed the clinical efficacy and safety of acupuncture for migraine, evaluations focusing only on acupuncture versus sham acupuncture are rare.…”

“… 10 , 26 Currently, increasingly more evidence supports the use of acupuncture in migraine patients. 44 , 45 Although a number of previous systematic reviews have confirmed the clinical efficacy and safety of acupuncture for migraine, evaluations focusing only on acupuncture versus sham acupuncture are rare. In this review, the findings indicated that acupuncture was superior to sham acupuncture for migraine treatment.…”