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Review
. 2024 Mar 15:17:1107-1132.
doi: 10.2147/JPR.S452971. eCollection 2024.

Efficacy of Acupuncture-Related Therapy for Migraine: A Systematic Review and Network Meta-Analysis

Yinqin Liu  1 , Yan Wang  2 , Chuanhao Mi  1 , Ziyue Wang  1 , Yu Han  1 , Xianghua Qi  3 , Xiao Ding  3
Affiliations
Review

Efficacy of Acupuncture-Related Therapy for Migraine: A Systematic Review and Network Meta-Analysis

Yinqin Liu et al. J Pain Res. .

Abstract

Objective: Migraine is a common neurological disorder, which resulting in significant societal and personal burdens. Acupuncture has attracted widespread attention in migraine prophylaxis and treatment in recent years. Although some studies have confirmed the effectiveness of acupuncture therapy in treating migraines, there is still a lack of comprehensive evaluation regarding the comparison between different types of migraines and various acupuncture therapies. Furthermore, certain special acupuncture methods have not received sufficient attention and research. Therefore, the objective of this study is to summarize and expand upon previous research, update existing evidence, and compare the efficacy of different acupuncture therapies for migraine. We aim to provide stronger evidence-based support for clinical practice through this study, thereby promoting wider application of acupuncture therapy in migraine treatment.

Methods: A exhaustive and methodical search was conducted across the nine databases: PubMed, EMBASE, Web of Science, Scopus, the Cochrane Library, CBM, CNKI, WANFANG and VIP Data. The Visual Analog Scale (VAS) scores, migraine attack frequency, duration, days of attack and adverse effects were observation indicators.

Results: This study included 34 studies involving a total of 3365 migraineurs. The results of the study demonstrated that acupuncture therapy reduced VAS scores of migraine patients better compared to medication (MD=-1.29, 95% CI=[-1.67,-0.92]) and exhibited greater efficacy in reducing the frequency of migraine attacks (MD=-1.95, 95% CI=[-3.06,-0.85]), the duration of attacks (MD=- 3.29, 95% CI=[-4.65,-1.93]), and days of attack (MD=-1.02, 95% CI=[-1.58,-0.47]). Significant heterogeneity suggested that different acupuncture therapies had varying effects, and that the efficacy of the same therapy may also vary in different migraine types. In the context of network meta-analysis, the SUCRA of acupuncture therapies for reducing VAS scores was ranked as special acupuncture method (98.3%), acupuncture plus medicine (71.9%), and acupuncture (54.5%). Blood-letting and cupping was the most effective treatment for lowering the frequency of migraine attacks. The most effective treatment for shortening the duration of migraine was acupuncture plus medication (81.2%). When it comes to decreasing the days of migraine, acupuncture (80.3%) came out on top. 14 studies reported the occurrence of adverse effects, of which 4 studies had no adverse effects in the test group.

Conclusion: Initial findings indicate that acupuncture-related therapy exhibits superior effectiveness in the treatment of migraine and clinical decision-making should be patient-specific.

Keywords: acupuncture; migraine; network meta-analysis; systematic review.

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Conflict of interest statement

The authors declare that they have no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Selection of included studies.
Figure 2
Figure 2
Risk of bias graph.
Figure 3
Figure 3
Risk of Bias summary. The three-arm study was equally divided into two groups-a and b. (1) and (2): Wang (1), Wang (2), Same author and year, but different studies.
Figure 4
Figure 4
The forest plot of VAS scores of migraine attacks after treatment for acupuncture, electroacupuncture, blood-letting and cupping, special acupuncture method and acupuncture plus conventional medicine versus conventional medicine of different migraine types. The three-arm study was equally divided into two groups-a and b. (1) and (2): Wang (1), Wang (2), Same author and year, but different studies.
Figure 5
Figure 5
The forest plot of frequency of migraine attacks after treatment for acupuncture, blood-letting and cupping, special acupuncture method and acupuncture plus conventional medicine versus conventional medicine of different migraine types. (1) and (2): Wang (1), Wang (2), Same author and year, but different studies.
Figure 6
Figure 6
The forest plot of duration of migraine after treatment for acupuncture, blood-letting and cupping, special acupuncture method and acupuncture plus conventional medicine versus conventional medicine of different migraine types. (1) and (2): Wang (1), Wang (2), Same author and year, but different studies.
Figure 7
Figure 7
The forest plot of days of migraine after treatment for acupuncture, electroacupuncture and acupuncture plus conventional medicine versus conventional medicine of different migraine types.
Figure 8
Figure 8
Network evidence map. (a) VAS scores: A: acupuncture; B: electroacupuncture; C: blood-letting and cupping; D: acupuncture plus conventional medicine; E: special acupuncture method; F: conventional medicine. (b) Frequency of migraine attacks: A: acupuncture; B: blood-letting and cupping; C: acupuncture plus conventional medicine; D: special acupuncture method; E: conventional medicine. (c) Duration of migraine: A: acupuncture; B: blood-letting and cupping; C: acupuncture plus conventional medicine; D: special acupuncture method; E: conventional medicine. (d) The number of migraine days: A: acupuncture; B: electroacupuncture; C: acupuncture plus conventional medicine; D: conventional medicine.
Figure 9
Figure 9
Two-by-two comparisons. (a) VAS scores: A: acupuncture; B: electroacupuncture; C: blood-letting and cupping; D: acupuncture plus conventional medicine; E: special acupuncture method; F: conventional medicine. (b) Frequency of migraine attacks: A: acupuncture; B: blood-letting and cupping; C: acupuncture plus conventional medicine; D: special acupuncture method; E: conventional medicine. (c) Duration of migraine: A: acupuncture; B: blood-letting and cupping; C: acupuncture plus conventional medicine; D: special acupuncture method; E: conventional medicine. (d) The number of migraine days: A: acupuncture; B: electroacupuncture; C: acupuncture plus conventional medicine; D: conventional medicine.
Figure 10
Figure 10
Order of the surface under the cumulative ranking area. (a) VAS scores: A: acupuncture; B: electroacupuncture; C: blood-letting and cupping; D: acupuncture plus conventional medicine; E: special acupuncture method; F: conventional medicine. (b) Frequency of migraine attacks: A: acupuncture; B: blood-letting and cupping; C: acupuncture plus conventional medicine; D: special acupuncture method; E: conventional medicine. (c) Duration of migraine: A: acupuncture; B: blood-letting and cupping; C: acupuncture plus conventional medicine; D: special acupuncture method; E: conventional medicine. (d) The number of migraine days: A: acupuncture; B: electroacupuncture; C: acupuncture plus conventional medicine; D: conventional medicine.
Figure 11
Figure 11
Funnel plot of network meta-analysis. (a) VAS scores: A: acupuncture; B: electroacupuncture; C: blood-letting and cupping; D: acupuncture plus conventional medicine; E: special acupuncture method; F: conventional medicine. (b) Frequency of migraine attacks: A: acupuncture; B: blood-letting and cupping; C: acupuncture plus conventional medicine; D: special acupuncture method; E: conventional medicine. (c) Duration of migraine: A: acupuncture; B blood-letting and cupping; C: acupuncture plus conventional medicine; D: special acupuncture method; E: conventional medicine. (d) The number of migraine days: A: acupuncture; B: electroacupuncture; C: acupuncture plus conventional medicine; D: conventional medicine.
Figure 12
Figure 12
Adverse events of interventions.
See this image and copyright information in PMC

References

    1. Headache Classification Committee of the International Headache Society (IHS); The international classification of headache disorders. Cephalalgia. 2018;38(1):1–211. doi:10.1177/0333102417738202 - DOI - PubMed
    1. Global; regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390(10100):1211–1259. doi:10.1016/S0140-6736(17)32154-2 - DOI - PMC - PubMed
    1. Reuter U. GBD 2016: still no improvement in the burden of migraine. Lancet Neurol. 2018;17(11):929–930. doi:10.1016/S1474-4422(18)30360-0 - DOI - PubMed
    1. Wang J, Wang X, Zhang X, et al. Clinical study on the effect of acupuncture on cognitive function in patients with migraine accompanied by depression/anxiety disorders. Chin Acupun. 2021;41(06):615–620. doi:10.13703/j.0255-2930.20201004-k0001 - DOI
    1. Chinese Society of Neurology HCGotCSoN. Chinese guidelines for the diagnosis and treatment of migraine. Chin J Neurol. 2023;56(06):591–613.