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. 2023 Sep 8:17:1211438.
doi: 10.3389/fnins.2023.1211438. eCollection 2023.

The durable effect of acupuncture for episodic migraine: a systematic review and meta-analysis

Hangyu Shi  1   2 , Runyu Miao  2   3 , Shuai Gao  1 , Lili Zhu  1 , Jiufei Fang  1 , Zhishun Liu  1
Affiliations

The durable effect of acupuncture for episodic migraine: a systematic review and meta-analysis

Hangyu Shi et al. Front Neurosci. .

Abstract

Background: Migraine is a common and recurrent type of headache. Avoiding trigger factors is not often successful in reducing headache frequency, duration, and severity. Prophylactic medications may be effective but are limited by strict indications and daily medication intake. This review aimed to investigate the durable effect of acupuncture on episodic migraine.

Methods: Seven databases including Medline, Embase, PubMed, etc., were searched for English and Chinese literature from their inception to 23 November 2022. Two independent reviewers screened the retrieved studies and extracted the data. Primary outcomes were monthly migraine days, monthly migraine attacks, and VAS score at 3 months post-treatment. The risk of bias in included studies was assessed using the Cochrane Risk of Bias 2.0 tool. Meta-analysis was conducted where applicable.

Results: Fifteen studies were included in this review. Acupuncture reduced the number of migraine attacks (MD -0.68; 95% CI -0.93, -0.43; p < 0.001), the number of days with migraine (MD -0.86; 95% CI -1.18, -0.55; p < 0.001), and VAS score (MD -1.01; 95% CI -1.30, -0.72; p < 0.001) to a greater degree than sham acupuncture at 3 months after treatment. Significant differences in reducing pain intensity of migraine in favor of acupuncture compared with waitlist (MD -1.84; 95% CI -2.31, -1.37; p < 0.001) or flunarizine (MD -2.00; 95% CI -2.35, -1.65; p < 0.001) at 3 months after treatment were found, and the differences reached the minimal clinically important difference (MCID).

Conclusion: This review found that the durable effect of acupuncture for episodic migraine lasted at least 3 months after treatment. More high-quality studies with longer follow-up periods in the future are needed to confirm the findings.

Keywords: RCTs; acupuncture; durable effect; migraine; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study. RCT, randomized controlled trial.
Figure 2
Figure 2
PRISMA flow diagram. RCT, randomized controlled trial.
Figure 3
Figure 3
(A) Risk of bias graph presented as percentages. (B) Cochrane Risk of Bias 2.0 Tool of included studies.
Figure 4
Figure 4
Forest plot of primary outcomes (acupuncture vs. sham acupuncture). (A) Total migraine days per month; (B) Attacks per month; (C) VAS score. SD, standard deviation; No., number of subjects; MD, mean difference; CI, confidence interval.
Figure 5
Figure 5
Forest plot of response rate (acupuncture vs. sham acupuncture). RR, relative risk.
Figure 6
Figure 6
Forest plot of primary outcomes (acupuncture vs. waitlist). (A) Total migraine days per month; (B) Attacks per month; (C) VAS score. SD, standard deviation; No., number of subjects; MD, mean difference; CI, confidence interval.
Figure 7
Figure 7
Forest plot of primary outcomes (acupuncture vs. flunarizine). (A) Total migraine days per month; (B) Attacks per month; (C) VAS score. SD, standard deviation; No., number of subjects; MD, mean difference; CI, confidence interval.
Figure 8
Figure 8
Schematic of the durable effect of acupuncture for episodic migraine.
See this image and copyright information in PMC

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