Treatment Of Tension-type Headache Research Articles

Tension-Type Headache Management: A Systematic Review and Network Meta-analysis of Complementary and Alternative Medicine.

Tension-type headache (TTH) is common but challenging to manage due to limited effectiveness of conventional treatments. This study examines six complementary and alternative medicine (CAM) interventions through network meta-analysis to identify effective TTH management strategies. We searched PubMed, Embase, Web of Science, Cochrane Library, OVID, CNKI, Wanfang, VIP, and CBM databases for randomized controlled trials on CAM for TTH treatment. Headache frequency and intensity were the primary outcomes. Methodological quality was evaluated on the basis of the Cochrane risk of bias tool. We used R software to conduct this Bayesian network meta-analysis. We used mean difference (MD) with 95% credible intervals (CI) to calculate the continuous outcomes and analyzed the percentages of the surface under the cumulative ranking (SUCRA) curve. In total, 32 randomized controlled trials (RCTs) with 2405 participants were analyzed. For reducing headache intensity, the network meta-analysis shows that acupuncture therapy combined with traditional Chinese medicine (AT_TCM), manual therapy (MT), psychological treatment (PT), and traditional Chinese medicine combined with acupuncture and manual therapy (TCM_AT_MT) are superior to Western medicine (WM). In the SUCRA curve, TCM_AT_MT is the best for reducing headache frequency (HF). This review, assessed as low-quality evidence by GRADE, cautiously suggests potential benefits of PT over other CAM interventions for TTH and indicates TCM_AT_MT might better reduce HF. It proposes that combining CAM interventions could enhance outcomes. Due to the preliminary nature of these findings, further high-quality RCTs are essential to confirm these suggestions and provide clearer clinical guidance. CRD42021252073.

Acupuncture versus tricyclic antidepressants in the prophylactic treatment of tension-type headaches: an indirect treatment comparison meta-analysis

BackgroundAcupuncture showed better improvement than sham acupuncture in reducing attack frequency of tension-type headache (TTH), but its effectiveness relative to first-line drugs for TTH is unknown, which impedes the recommendation of acupuncture for patients who are intolerant to drugs for TTH. We aimed to estimate the relative effectiveness between acupuncture and tricyclic antidepressants (TCAs) through indirect treatment comparison (ITC) meta-analysis.MethodsWe searched Ovid Medline, Embase, and Cochrane Library from database inception until April 13, 2023. Randomized controlled trials of TCAs or acupuncture in the prevention of TTH in adults were included. The primary outcome was headache frequency. The secondary outcomes were headache intensity, responder rate, and adverse event rate. Bayesian random-effect models were used to perform ITC meta-analysis, and confidence of evidence was evaluated by using the GRADE approach.ResultsA total of 34 trials involving 4426 participants were included. Acupuncture had similar effect with TCAs in decreasing TTH frequency (amitriptyline: mean difference [MD] -1.29, 95% CI -5.28 to 3.02; amitriptylinoxide: MD -0.05, 95% CI -6.86 to 7.06) and reducing TTH intensity (amitriptyline: MD 2.35, 95% CI -1.20 to 5.78; clomipramine: MD 1.83, 95% CI -4.23 to 8.20). Amitriptyline had a higher rate of adverse events than acupuncture (OR 4.73, 95% CI 1.42 to 14.23).ConclusionAcupuncture had similar effect as TCAs in reducing headache frequency of TTH, and acupuncture had a lower adverse events rate than amitriptyline, as shown by very low certainty of evidence.

Greater Occipital Nerve Blockade in the Treatment of Tension-type Headaches in the Emergency Department

Greater Occipital Nerve Blockade in the Treatment of Tension-type Headaches in the Emergency Department

Effects on temporomandibular disorder in the treatment of tension-type headache with acupuncture and therapeutic exercises. A secondary analysis from a randomized controlled trial

Objectives To examine the effects of acupuncture and therapeutic exercise alone and in combination on temporomandibular joint symptoms in tension-type headache and to evaluate the potential interaction of existing temporomandibular dysfunction on the success of headache treatment. Design Pre-planned secondary analysis of a randomized controlled, non-blinded trial. Setting Outpatient clinic of a German university hospital. Subjects Ninety-six Participants with frequent episodic or chronic tension-type headache were randomized to one of four treatment groups. Interventions Six weeks of acupuncture or therapeutic exercise either as monotherapies or in combination, or usual care. Follow-up at 3 and 6 months. Main measures Subjective temporomandibular dysfunction symptoms were measured using the Functional Questionnaire Masticatory Organ, and the influence of this sum score and objective initial dental examination on the efficacy of headache treatment interventions was analyzed. Results Temporomandibular dysfunction score improved in all intervention groups at 3-month follow-up (usual care: 0.05 [SD 1.435]; acupuncture: −5 [SD 1.436]; therapeutic exercise: −4 [SD 1.798]; combination: −3 [SD 1.504]; P = 0.03). After 6 months, only acupuncture (−6 [SD 1.736]) showed a significant improvement compared to the usual care group (P < 0.01). Subjective temporomandibular dysfunction symptoms had no overall influence on headache treatment. Conclusions Only acupuncture had long-lasting positive effects on the symptoms of temporomandibular dysfunction. Significant dental findings seem to inhibit the efficacy of acupuncture for tension-type headache.

Headache in the general practice

Headaches are one of the most frequent causes of consultations in general practice. Of more than 350 known headache tendencies, tension-type headache and migraine are particularly common in general practice. Medication overuse headache (MOH) is also common but rarely diagnosed. The medical consultation with a targeted anamnesis is the cornerstone of the diagnosis and correct classification. A detailed neurological examination completes the basic diagnosis. Additional laboratory and instrumental diagnostics follow in cases of atypical headache or clinical suspicion of secondary headache. This article focuses on the diagnosis and treatment of Tension-type Headache, migraine and Medication Overuse Headache.

Treatment of tension-type headache

Treatment of tension-type headache

A Bibliometric Analysis of Acupuncture Treatment of Tension-Type Headache from 2003 to 2022.

Acupuncture therapy is a unique technology created by the working people in ancient China. It is popular all over the world for its safety, effectiveness and no side effects, especially for the treatment of pain syndrome, it can often have an immediate effect. Tension-type headache is one of them. At present, many literatures have reported that many countries in the world are using acupuncture to treat tension-type headache, but there is no quantitative analysis of the relevant literature on this field. Therefore, This study aims to evaluate the research hotspots and trends of acupuncture treatment of tension-type headache through a macro review of the literature from 2003 to 2022 by using CiteSpace V6.1.R6 (64-bit) Basic. Relevant literatures on acupuncture treatment of tension-type headache from 2003 to 2022 were extracted from the web of science core collection database. CiteSpace was used to analyze the data of publications, authors, institutions, countries, keywords and cited references, cited authors, cited journals. Draw the cited network map and analyze the research hotspots and trends. A total of 231 publications were retrieved from 2003 to 2022. In the past 20 years, the annual number of publications has shown an overall growth trend, and the most active journals, countries, institutions, authors, cite references and keywords in the field of acupuncture treatment of tension-type headache were identified. This study provides the status and trends of clinical research in the field of acupuncture therapy for tension-type headache in the past 20 years, which will help researchers understand the research hotspots in this field and provide new directions for further research.

The influence of osteopathic correction on liquorodynamics in patients with tension-type headache

Introduction. Tension-type headache (TTH) is known to be the most common type of headache in all age groups. The guidelines of the European Federation of Neurological Societies, the Italian Guidelines for Primary Headaches and the Italian Consensus Conference on Pain in Neurorehabilitation report that non-pharmacological therapies are valid adjunctive treatments for TTH. Previous studies have shown that the use of general osteopathic treatment in patients with TTH is accompanied by a significant decrease in the severity of pain syndrome and asthenic condition. We did not find any scientific publications devoted to the objectification of the results of osteopathic correction in TTH using magnetic resonance imaging (MRI).The aim of the study was to objectify the results of osteopathic correction by assessing changes in the liquor dynamics of the posterior cranial fossa in patients with tension-type headache.Materials and methods. The study was conducted from December 2020 to December 2021 at the clinic of the Center for New Medical Technologies, Novosibirsk. There were under the observation 10 patients with an established diagnosis of TTH aged from 18 to 55 years, 4 men, and 6 women. All patients before the start of treatment and after the course completion were assessed for their osteopathic status and underwent high-field MRI 3T of the brain with the calculation of the posterior cranial fossa restriction index (CFRI). CFRI reflects the state of liquorodynamics at the level of the skull base and shows the level of freedom in the relationship between fluid spaces and brain tissues. Study participants received a course of osteopathic correction, which included 3–4 procedures with an interval of 5–7 days. The observed patients did not receive any other therapy during the study period.Results. The examined patients were most characterized by regional biomechanical disorders (RBD): head (9); neck, structural component (5); thoracic, visceral component (5); dura mater region (9). In terms of severity, mild RBD prevailed (1 point). After treatment, patients have a decrease of the detection frequency of major regional somatic dysfunctions (SD). Statistically significant differences (p&lt;0,05) were obtained in the SD incidence of head region; neck region, structural component; thoracic, visceral component; dura mater region. A statistically significant (p&lt;0,05) increase in the mean CFRI from 30,22±0,63 to 31,78±0,73 % was found after the treatment.Conclusion. The results of the high-field MRI with the study of CFRI allow to quantitatively assess the changes of the cerebrospinal fluid dynamics in patients with tension-type headache, and it can be used as an objective criterion for the osteopathic correction results and the therapy clinical effectiveness. The study should be continued with a more representative sample.

Randomized Double-Blind Comparison of Intravenous Ibuprofen and Dexketoprofen in the Acute Treatment of Tension-Type Headache

Abstract: Non-steroidal anti-inflammatory drugs are used routinely and first choice in the acute treatment of tension-type headaches(TTH). The aim of this study is to compare the analgesic efficacy of parenterally administered single dose dexketoprofen and ibuprofen in the treatment of TTH. Our study was designed in a randomized, double-blind model. Patients with tension headache were randomized to dexketoprofen and ibuprofen groups. Pain scores of the patients were recorded at 0, 15, 30, and 60 minutes with a 10-unit Numeric Rating Scale (NRS). Of these patients, 45 (50%) were included in the group to receive dexketoprofen treatment, and 45 (50%) to receive ibuprofen treatment. In total, 54 of our patients were female and 36 were male. The differences in mean NRS scores in the group treated with analgesic 1 were 2.0, 4.0, 5.22, 6.0 at the end of the 5th, 15th, 30th and 60th minutes, respectively, and 2, 5, 6.36, 7 for analgesic 2, respectively. While there was no significant difference between drug efficacy at all time points except the 30th minute, the efficacy of ibuprofen in reducing pain was more significant at the 30th minute (p=.015). As a result of our study, there was no significant difference between the analgesic efficacy of parenterally administered dexketoprofen 50 mg and ibuprofen 800 mg at the end of the 60th minute, while ibuprofen 800 mg was superior in terms of analgesic efficacy at the 30th minute.

Infra-Low Frequency Neurofeedback in Tension-Type Headache: A Cross-Over Sham-Controlled Study.

Primary headaches are highly prevalent and represent a major cause of disability in young adults. Neurofeedback is increasingly used in the treatment of chronic pain; however, there are few studies investigating its efficacy in patients with headaches. We report the results of a cross-over sham-controlled study on the efficacy of neurofeedback in the prophylactic treatment of tension-type headache (TTH). Participants received ten sessions of infra-low frequency electroencephalographic neurofeedback and ten sessions of sham-neurofeedback, with the order of treatments being randomized. The study also included a basic psychotherapeutic intervention — a psychoeducational session performed before the main study phases and emotional support provided throughout the study period. The headache probability was modeled as a function of the neurofeedback and sham-neurofeedback sessions performed to date. As a result, we revealed a strong beneficial effect of neurofeedback and no influence of the sham sessions. The study supports the prophylactic use of infra-low frequency neurofeedback in patients with TTH. From a methodological point of view, we advocate for the explicit inclusion of psychotherapeutic components in neurofeedback study protocols.

Guided imagery intervention for the treatment of tension-type headache associated with state-trait anxiety

Introduction: Guided imagery (GI) is a mind–body intervention, in which individuals generate mental images of pleasant objects or events in their minds. These mental images produce positivity and alter the perception of headaches and other pain disorders. A review of literature suggests that GI is an effective psychological treatment for tension-type headache (TTH) and state-trait anxiety. Hence, the present study aimed to assess the efficacy of GI on TTH associated with state-trait anxiety and to compare its efficacy with treatment as usual (TAU). Materials and Methods: Forty treatment-naïve patients diagnosed with TTH were selected from the psychiatry outpatient department through purposive sampling method. The Henry Ford Hospital Headache Disability Inventory and the State-Trait Anxiety Inventory for Adults were administered on all the patients for baseline data. Experimental group (n = 20) were given eight sessions of GI along with TAU for 2 months, whereas waitlist group (n = 20) were given only TAU. Results: A Significant positive association was obtained between emotional and functional disability of headache and state-trait anxiety at baseline. Postassessment findings demonstrated a significant reduction in severity and frequency of TTH, emotional and functional disability, and state-trait anxiety in the experimental group receiving GI as compared to the waitlist group. Conclusion: Patients living with TTH more commonly suffer from state-trait anxiety. Those patients who were given GI along with TAU for 2 months improved on severity and frequency of TTH, emotional and functional disability of TTH, and state-trait anxiety more effectively than those patients receiving only TAU. Consequently, it can be said that GI is an effective treatment for TTH and state-trait anxiety as compared to TAU.

Evidence mapping of clinical research on 28 Chinese patent medicines for tension-type headache

In this study, the evidence mapping methodology was used to systematically retrieve and sort out the clinical research evidence of Chinese patent medicines in the treatment of tension-type headache(TTH), and to understand the distribution of evidence in this field and the basis and quality of evidence. Chinese and English articles on the 28 Chinese patent medicines for TTH, which were recorded in National Essential Medicines List(2018), Medicine Catalogue for National Basic Medical Insurance, Work Injury Insurance, and Maternity Insurance(2020), and Chinese Pharmacopoeia(2020), were retrieved from China National Knowledge Infrastructure(CNKI), Wanfang, VIP, China Biology Medicine disc(CBMdisc), PubMed, EMbase, and Cochrane Library from the establishment to June 2021, followed by descriptive analysis. Then, tables and bubble charts were plotted to analyze the distribution characteristics of evidence. A total of 129 eligible articles were yielded: 126 randomized/non-randomized controlled trials, and 3 systematic reviews. The functions, indications, and composition of the 28 medicines, as well as the proportion of related articles, publication trends, intervention measures, and outcome indicators were compared and analyzed. The results showed that the 28 Chinese patent medicines, composed of 128 Chinese medicinals, can be classified into six categories in terms of function: reinforcing healthy Qi, tranquilizing mind, dispelling stasis, regulating Qi, treating wind, and resuscitating. There are ongoing efforts to study the treatment of TTH with Chinese patent medicine in China, despite of little evidence. The clinical positioning of Chinese patent medicine for TTH is not clear, and clinical research fails to highlight the advantages of Chinese medicine. In addition, the outcome indicators have not been standardized and unified, and there is a lack of evidence on the long-term efficacy of Chinese patent medicine for TTH. This study is the first exploratory application of evidence maps to compare the characteristics and clinical research progress of 28 Chinese patent medicines for TTH, which can provide a reference for research on the optimization of Chinese medicine strategies for TTH.

Amplitude of Low-Frequency Fluctuation in Multiple Frequency Bands in Tension-Type Headache Patients: A Resting-State Functional Magnetic Resonance Imaging Study.

Purpose: Tension-type headache (TTH), the most prevalent primary headache disorder, imposes an enormous burden on the people of the world. The quest to ease suffering from this neurological disorder has sustained research interest. The present study aimed at evaluating the amplitude of low-frequency oscillations (LFOs) of the brain in multiple frequency bands in patients with TTH.Methods: To address this question, 63 participants were enrolled in the study, including 32 TTH patients and 31 healthy controls (HCs). For all the participants, amplitude of low-frequency fluctuation (ALFF) was measured in six frequency bands (conventional frequency bands, 0.01–0.08 Hz; slow-2, 0.198–0.25 Hz; slow-3, 0.073–0.198 Hz; slow-4, 0.027–0.073 Hz; slow-5, 0.01–0.027 Hz; and slow-6, 0–0.01 Hz), and the differences between TTH patients and HCs were examined. To explore the relationship between the altered ALFF brain regions in the six frequency bands and the Visual Analog Scale (VAS) score in the TTH patients, Pearson’s correlation analysis was performed.Results: In all the six frequency bands, a decreased ALFF value was detected, and regions showing reduced ALFF values were mostly located in the middle frontal gyrus and superior gyrus. A frequency-dependent alternating characterization of intrinsic brain activity was found in the left caudate nucleus in the slow-2 band of 0.198–0.25 Hz and in the right inferior frontal orbital gyrus in the slow-5 band of 0.01–0.027 Hz. For the correlation results, both the left anterior cingulate and paracingulate gyri and right superior parietal gyrus showed a positive correlation with the VAS score in the slow-4 frequency band of 0.027–0.073 Hz.Conclusion: The ALFF alterations in the brain regions of TTH patients are involved in pain processing. The altered LFOs in the multiple regions may help promote the understanding of the pathophysiology of TTH. These observations could also allow the future treatment of TTH to be more directional and targeted and could promote the development of TTH treatment.

Systematic review and Meta-analysis of efficacy and safety of gastrodin in treatment of tension-type headache

The efficacy of gastrodin as a Chinese herbal medicine extract in the treatment of tension-type headache has been confirmed. This paper systematically reviewed the efficacy and safety of gastrodin in the treatment of tension-type headache, aiming to provide a new choice for the treatment of this disease. In this study, four Chinese databases, four English databases and two trial registries were searched from the date of establishment to September 2020. The related randomized controlled trials(RCTs) were screened out according to the predetermined criteria. The bias risk assessment tool developed by Cochrane collaboration was used to evaluate the quality of the reports. RevMan 5.4.1 was used for Meta-analysis, and GRADE system for the evidence-based evaluation on the quality of outcome indicators. A total of 177 articles were retrieved and 8 articles were finally included for analysis, with a total sample size of 1 091 cases, which included 565 cases in the treatment group and 526 cases in the control group. The overall quality of included stu-dies was not high. The results of Meta-analysis are as follows:(1)In terms of headache frequency, gastrodin group was better than wes-tern medicine group(MD=-2.90, 95%CI[-3.76,-2.03], P&lt;0.000 01).(2)In terms of number of abnormal blood vessels in TCD, gastrodin group was better than western medicine group(MD=-88.96, 95%CI[-102.36,-75.55], P&lt;0.000 01).(3)In terms of effective rate, gastrodin group was better than western medicine group(RR=1.47, 95%CI[1.29, 1.68], P&lt;0.000 01). The results of subgroup analysis are as follows:(1)Effective rate based on age, for the patients upper age limit 40-46 years old, gastro-din group was better than western medicine group(RR=1.69, 95%CI[1.50, 1.90], P&lt;0.000 01); for the patients upper age limit 55-60 years old, gastrodin group was better than western medicine group(RR=1.27, 95%CI[1.16, 1.38], P&lt;0.000 01).(2)Effective rate based on dosage form, both the gastrodin capsules and injection groups were better than western medicine group(RR_(capsules)=1.42, 95%CI[1.08, 1.88], P=0.01; RR_(injection)=1.50, 95%CI[1.26, 1.77], P&lt;0.000 01). GRADE evaluation showed that the above outcomes had low quality of evidence. Only one article detailed the occurrence of adverse reactions and thus the present study cannot make a positive conclusion on the safety of gastrodin in the treatment of tension-type headache. The small number and low quality of the included reports affected the reliability of the results. In the future, more high-quality randomized controlled trails are needed to improve the evaluation on the efficacy and safety of gastrodin in the treatment of tension-type headache.

Outcome indicators in randomized controlled trials on traditional Chinese medicine intervention for tension-type headache in recent five years

To evaluate the application of outcome indicators in randomized controlled trials(RCTs) concerning the treatment of tension-type headache(TTH) with traditional Chinese medicine(TCM) in recent five years, so as to provide a basis for the study of core outcome set(COS) for TCM intervention in TTH. The RCTs on TCM treatment of TTH in recent five years were systematically retrieved from CNKI, Wanfang, VIP, CBM, EMbase, PubMed, Cochrane Library, Web of Science, ClinicalTrials.gov and China Clinical Trial Registry. After literature screening, data extraction and evaluation of the risk of bias, the outcome indicators in the included RCTs were subjected to qualitative analysis. The preliminary search yielded 19 042 articles, and 10 983 were left after the elimination of duplication. Finally, 52 RCTs(48 in Chinese and 4 in English) were included for qualitative analysis. The outcome indicators of RCTs included in this study were classified into seven domains: TCM syndrome, symptom and sign, physical and chemical detection, quality of life, long-term prognosis, economic evaluation, and safety event. The findings demonstrated that headache characteristic index in the symptom and sign domain was the index with the highest reporting frequency and reporting rate. Seventeen RCTs used TCM syndrome score as the outcome indicator. Further analysis revealed that there existed such problems in research design as non-distinction between primary and secondary outcome indicators, great difference in the adopted measurement tools for outcome indicators, and the neglect of measurement time of outcome indicators. Moreover, the syndrome indicators reflecting TCM advantages, objective evaluation indicators, safety and health-economic indicators were lacking. These limitations have affected the quality and reliability of RCTs on TTH treatment with TCM. It is suggested that the efficacy and characteristics of TCM should be combined into current clinical research, and the COS in RCTs regarding TCM treatment of TTH should be established according to internationally recognized standard procedures.

Systematic review and Meta-analysis of efficacy and safety of Toutongning Capsules in treatment of tension-type headache

This study aims to systematically evaluate the clinical efficacy and safety of Toutongning Capsules in the treatment of tension-type headache(TTH), so as to provide a corresponding basis for clinical treatment. Eight commonly used medical research databases and two clinical trial registration systems were retrieved with the time interval from the establishment of the database or system to November 2020. The randomized controlled trials of Toutongning Capsules in the treatment of TTH were screened out according to the pre-set criteria. The quality of the included papers was evaluated by the bias risk assessment tool in Cochrane Reviewers Handbook 6.1 and the data were statistically analyzed by RevMan v5.4 provided by Cochrane collaboration. A total of 13 studies were included and the quality of methodology was generally low. Meta-analysis showed that Toutongning Capsules assisted with western medicine therapy can effectively reduce the pain intensity(MD_(VAS)=-1.94,95%CI[-2.50,-1.38],P&lt;0.000 01;MD_(NRS)=-0.83,95%CI[-0.86,-0.80],P&lt;0.000 01), headache duration(SMD=-0.98,95%CI[-1.17,-0.79],P&lt;0.000 01), headache frequency(MD=-1.01,95%CI[-1.16,-0.85],P&lt;0.000 01), headache index(MD=-11.13,95%CI[-12.10,-10.16],P&lt;0.000 01), anxiety and depression scale score(MD_(HAMA)=-4.02,95%CI[-6.58,-1.46],P=0.002;MD_(HAMD)=-2.67,95%CI[-4.04,-1.29],P=0.000 1), while Toutongning Capsules as monotherapy only reduced the headache score(MD=-2.24,95%CI[-2.97,-1.51],P&lt;0.000 01). The available clinical studies demonstrate that Toutongning Capsules combined with western medicine in the treatment of TTH can improve the related outcome indicators, but the clinical safety and efficacy of Toutongning Capsules alone remain unclear. Due to the small number and low quality of the included studies, large-sample, multi-center, high-quality and strictly designed randomized controlled trials are still needed to verify the clinical efficacy in the future.

Using pharmacopuncture for chronic tension-type headache treatment

Objective: assessing pharmacopuncture effect on pain syndrome and level of anxiety-depressive disorders in patients with chronic tension-type headache (CTTH). Materials and methods. An open-label controlled trial was conducted on 95 CTTH patients split among two groups by means of adaptive randomization. The comparison group subjects were receiving 35-70 mg/day of amitriptyline and 450 mg/day of tolperisone, while patients of the treatment group were assigned 2-4 courses of pharmacopuncture by the original method. The results were evaluated on the basis of the scores obtained via Visual Analogue Scale (VAS), McGill Pain Questionnaire, Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI) sensu Ch. Spielberger and Yu. Khanin. Results. Patients in both clinical groups were inclined to a positive evaluation of received treatment. Based on the results of McGill Pain Questionnaire, we determined both affective and sensory pain descriptors, with a predominance of the latter. Both groups exhibited moderate depressive symptoms according to BDI of the psychological status. Prevalence of trait anxiety over reactive anxiety was determined by STAI. According to VAS, pain intensity after the treatment declined from 5.26±0.87 to 1.7±0.78 points (p&lt;0.05) and from 5.17±0.78 to 1.65±0.79 (p&lt;0.05) in the comparison group versus the treatment group. An improvement of anxiety and depression indicators was detected. Conclusion. Our results have demonstrated that pharmacopuncture is very promising in treating CTTH patients

Complementary and alternative therapies for tension-type headache: A protocol for systematic review and network meta-analysis.

Background:Tension-type headache (TTH) is the most common form of primary headache with high prevalence, which affects the quantity of life seriously. The pharmacological treatment of TTH is not the most effective. Meanwhile, complementary therapies and alternative therapies play an essential role in the treatment of TTH, and there is an absence of comparison between various interventions. Therefore, we propose the network meta-analysis protocol to compare the efficacy and safety of various complementary therapies and alternative therapies for TTH.Methods:From the beginning to February 2021, we will search the database to collect randomized controlled trials of complementary and alternative therapies for TTH. Two researchers will be responsible for screening retrieve documents, extracting data. The risk of bias will be assessed based on the Cochrane bias risk tool. We will use STATA16.0 and WinBUGS1.4.3 for paired meta-analysis and Bayesian network meta-analysis. The quality of evidence will be assessed using the grading of recommendations assessment development and evaluation.Results:This study will compare and rank the efficacy and safety of various complementary and alternative treatments for TTH.Conclusions:This study will provide more extensive evidence for the complementary and alternative therapies of TTH. We expect to assist clinicians and patients in choosing the optimum treatment.Protocol registration number:INPLASY202130088.

COMPARATIVE EFFECTS OF IV INJECTION OF KETOPROFEN AND PARACETAMOL IN THE TREATMENT OF TENSION-TYPE HEADACHE

Background: Headaches are one of the commonly reported issues throughout the world population. Globally, Tension-type headache is a more common problem. Individuals facing long occurring and more severe headaches may go for care from the medical facility. However, most of the individuals do not do so which usually consequences in inappropriate and inadequate management of this problem.&#x0D; Objective: The aim of the present study is to compare the effectiveness of ketoprofen IV injection and paracetamol IV injection in the treatment of tension-type headache.&#x0D; Methodology: A validated questionnaire was designed to conduct this study. Certain inclusion and exclusion criteria were established to select the participants. Patients having the age between 20 to 40 years were treated with paracetamol and ketoprofen and their responses were recorded and evaluated.&#x0D; Results: Our results suggest that paracetamol has more vital signs stability when compared with ketoprofen and is safer in terms of drug-induced allergic reaction and injection site reaction. However, ketoprofen has a faster onset of action when compared with paracetamol.&#x0D; Conclusion: Management of tension-type headache is neglected most of the time which affects the quality of life and productivity in the affected population. Development and update of existing guidelines for tension-type headache are essential in managing this issue. Both ketoprofen and paracetamol are effective in treating this issue but both have some side effects. Future studies are still desired to further evaluate their effects.&#x0D; Keywords: Tension-type headache, Headache, analgesics, Ketoprofen, Paracetamol

Tension-type headache in children and adolescents: comparative study of the effectiveness of preventive therapy methods

Introduction. Late and inaccurate diagnosis of tension-type headache (TTH) leads to the lack of timely rational treatment. In children and adolescents with TTH, the role of comorbid disorders that affect the course of TTH and can contribute to their chronification is not sufficiently taken into account. Meanwhile, with timely diagnosis and adequate treatment of TTH in many children and adolescents, a significant improvement in the disease’s course and the prognosis is achieved, and clinical remission is possible. Considering the high prevalence of TTH among children and adolescents, the decline in their quality of life, and the high frequency of comorbid disorders, it is reasonable to develop effective methods of preventive treatment for TTH in this age group. The aim of the study was to evaluate the effectiveness of monotherapy with γ-amino-β-phenyl butyric acid hydrochloride, amitriptyline, or breathing gymnastics (comparison group) indicated for two months as a preventive treatment of TTH in children and adolescents in the open randomized comparative study in three parallel groups of patients. Material and methods. In an open parallel study, 90 TTH patients aged 8-16 years were divided into three groups of 30 patients (each with 15 boys and 15 girls). Results. Significant differences with the comparison group in the individual response to therapy were confirmed. According to the criterion of a 50% or more reduction in the average number of headache attacks per month in group 1 (γ-amino-β-phenyl butyric acid hydrochloride), the improvement was achieved in 56.7% of patients, in group 2 (amitriptyline) - in 73.3%, in the 3rd group (breathing gymnastics) - in 30%. According to a more strict criterion for reducing the average number of headache attacks per month by 75% or more, the response to therapy was observed in group 1 in 30%. In group 2 - in 23.3%, in group 3 - in 3.3% of patients. In groups 1 and 2, along with a significant decrease in the frequency, duration, and intensity of TTH attacks, a significant improvement in daily activity, a favorable effect on the manifestations of fatigue, anxiety disorders, and sleep disorders associated with TTH was demonstrated. The therapeutic efficacy of breathing gymnastics exercises complex was confirmed in the prevention of TTH with frequency, duration, and intensity reduction of TTH, and diminishing its impact on daily activity, a moderate decrease in manifestations of fatigue, anxiety disorders (by patients’ self-assessment), and improvement in sleep quality.