Abstract
Objectives To review the evidence of acupuncture for acute and preventive treatment of migraine for further awareness of the effect of acupuncture for migraine. Design An overview of systematic reviews and meta-analyses (SR/MAs) for randomized controlled trials. Material and Methods We searched PubMed, Embase, the Cochrane Library, China Knowledge Resource Integrated Database, VIP Chinese Journal Full Text Database, WANFANG Data, and China Biology Medicine disc from their establishment to May 27, 2018. SR/MAs of randomized controlled trials comparing the effect of the acupuncture intervention with another treatment control in migraine patients were included. Results 428 SRs were identified, and 15 of them were included. Only 4 SR/MAs were assessed by GRADE, which showed certainty of most evidence being low or very low. Assessed by AMSTAR-2, fourteen was critically low rating overall confidence in the results, and 1 was low rating overall confidence in the results. Evidence suggested that acupuncture has a significant advantage of pain improvement, efficacy, and safety relative to blank control, sham acupuncture, or drug treatment, but some of these results are contradictory. Conclusions We found that acupuncture on treating migraine has the advantage for pain improvement and safety, but the quality of SR/MAs of acupuncture for migraine remains to be improved.
Highlights
Migraine is a common disabling primary headache disorder [1]
Evidence suggested that acupuncture has a significant advantage of pain improvement, efficacy, and safety relative to blank control, sham acupuncture, or drug treatment, but some of these results are contradictory
We found that acupuncture on treating migraine has the advantage for pain improvement and safety, but the quality of systematic reviews/meta-analyses (SR/MA) of acupuncture for migraine remains to be improved
Summary
Migraine is a common disabling primary headache disorder [1]. Epidemiological studies revealed that the global agestandardized prevalence of migraine was 14.4% (13.8–15.0%) in 2016, and this figure was 18.9% (18.1–19.7) for women and 9.8% (9.4–10.2) for men; in addition, the prevalence by ages increased significantly until reaching a peak between 35 and years and decreased smoothly after years, and for China, the prevalence of migraine was 9.3% (8.5–10.1%) in 2009 [2, 3]. Migraine has two major subtypes, “migraine without aura” and “migraine with aura,” and the mechanism of migraine is related to vascular, pain pathway, central system [1]. TCM theory believes that a kind of critical energy called Qi maintains the regular operation of the human body and this energy flows in a network of channels called meridians. E theory of TCM believes the human body will suffer from illness or disease once this flow is abnormal, which can be recovered by inserting the needle in some specified points on the channels of meridians of the human body like acupuncture. Acupuncture is often used to treat headache including migraine [7], and its therapeutic mechanism may be related to its regulation of nitric oxide synthase and 5-hydroxytryptamine (5-HT) gene1F expression to improve cerebral vasodilation and contraction [8]
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