Acupuncture for Treating Acute Attacks of Migraine: A Randomized Controlled Trial

• Published in: Headache Vol. 49; no. 6; pp. 805 - 816
• Main Authors: Li, Ying, Liang, Fanrong, Yang, Xuguang, Tian, Xiaoping, Yan, Jie, Sun, Guojie, Chang, Xiaorong, Tang, Yong, Ma, Tingting, Zhou, Li, Lan, Lei, Yao, Wen, Zou, Ran
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.06.2009; Wiley-Blackwell
• Subjects: Acupuncture Analgesia - methods; Acupuncture Analgesia - statistics & numerical data; Acupuncture Points; acupuncture therapy; Acute Disease; acute migraine; Adult; Aged; Biological and medical sciences; Cardiovascular system; China; Female; Humans; Male; Medical sciences; Middle Aged; Migraine Disorders - physiopathology; Migraine Disorders - therapy; Neurology; Outcome Assessment (Health Care) - methods; Pain - physiopathology; Pain Management; Pain Measurement - methods; Pharmacology. Drug treatments; Reproducibility of Results; sham acupuncture; Time Factors; traditional Chinese medicine; Treatment Outcome; Vascular diseases and vascular malformations of the nervous system; Vasodilator agents. Cerebral vasodilators; Young Adult; China; sham acupuncture; Headache; Nervous system diseases; Migraine; Cardiovascular disease; traditional Chinese medicine; Cerebral disorder; Vascular disease; acupuncture points; acupuncture therapy; acute migraine; Pain; Treatment; Central nervous system disease; Chinese; Acupuncture; Neurological disorder; Cerebrovascular disease
• ISSN: 0017-8748; 1526-4610; 1526-4610
• DOI: 10.1111/j.1526-4610.2009.01424.x

Objective.— To discuss the results of a multicenter randomized controlled trial of the efficacy of verum acupuncture in treating acute migraine attacks. Background.— Acupuncture has been used in China for centuries to treat migraine headache. Convincing evidence of its efficacy in alleviating pain, however, has been inadequate to date. Methods.— A total of 218 patients with migraine were recruited for the study; 180 met the inclusion criteria; 175 completed the callback process and were randomized into 3 groups. One group received verum acupuncture while subjects in the other 2 groups were treated with sham acupuncture. Each patient received 1 session of treatment and was observed over a period of 24 hours. The main outcome measure was the differences in visual analog scale (VAS) scores before treatment and 0.5, 1, 2, and 4 hours after treatment. Results.— Significant decreases in VAS scores from baseline were observed in the fourth hour after treatment when VAS was measured in the patients who received either verum acupuncture or sham acupunctures (P < .05). The VAS scores in the fourth hour after treatment decreased by a median of 1.0 cm, 0.5 cm, and 0.1 cm in the verum acupuncture group, sham acupuncture group 1, and sham acupuncture group 2, respectively. Similarly, there was a significant difference in the change in VAS scores from baseline in the second hour after treatment among the 3 groups (P = .006). Moreover, at the second hour after treatment, only patients treated with verum acupuncture showed significant decreases in VAS scores from baseline by a median of 0.7 cm (P < .001). Significant differences were observed in pain relief, relapse, or aggravation within 24 hours after treatment as well as in the general evaluations among the 3 groups (P < .05). Most patients in the acupuncture group experienced complete pain relief (40.7%) and did not experience recurrence or intensification of pain (79.6%). Conclusion.— Verum acupuncture treatment is more effective than sham acupuncture based on either Chinese or Western nonacupoints in reducing the discomfort of acute migraine. Verum acupuncture is also clearly effective in relieving pain and preventing migraine relapse or aggravation. These findings support the contention that there are specific physiological effects that distinguish genuine acupoints from nonacupoints.