Efficacy of acupuncture for migraine prophylaxis: A single-blinded,double-dummy,randomized controlled trial

Insufficient clinical trial data were available to prove the efficacy of acupuncture for migraine prophylaxis. A multicenter, double-dummy, single-blinded, randomized controlled clinical trial was conducted at the outpatient departments of acupuncture at 5 hospitals in China to evaluate the effectiveness of acupuncture. A total of 140 patients with migraine without aura were recruited and assigned randomly to 2 different groups: the acupuncture group treated with verum acupuncture plus placebo and the control group treated with sham acupuncture plus flunarizine. Treated by acupuncture 3 times per week and drugs every night, patients from both groups were evaluated at week 0 (baseline), week 4, and week 16. The primary outcome was measured by the proportion of responders (defined as the proportion of patients with a reduction of migraine days by at least 50%). The secondary outcome measures included the number of migraine days, visual analogue scale (VAS, 0 to 10 cm) for pain, as well as the physical and mental component summary scores of the 36-item short-form health survey (SF-36). The patients in the acupuncture group had better responder rates and fewer migraine days compared with the control group (P<.05), whereas there were no significant differences between the 2 groups in VAS scores and SF-36 physical and mental component summary scores (P>.05). The results suggested that acupuncture was more effective than flunarizine in decreasing days of migraine attacks, whereas no significantly differences were found between acupuncture and flunarizine in reduction of pain intensity and improvement of the quality of life.     

EFFECTS OF LONG-TERM ACUPUNCTURE TREATMENT ON RESTING-STATE BRAIN ACTIVITY IN MIGRAINE PATIENTS:A COMPARATIVE STUDY ON ACTIVE ACUPOINTS AND INACTIVE ACUPOINTS

Objective: Acupuncture has been commonly used for preventing attacks and relieving pain, although there is limited knowledgeon the physiological mechanism behind this method.The objectives of this study were to compare the differences in brain activities evoked by active acupoints and inactive acupoints and to investigate the possible correlation between clinical efficacy and brain responses.Methods: Eighty migraineurs without aura were enrolled to receive either active acupoint acupuncture or inactive acupoint acupuncture treatment for 8 weeks.Twenty patients in each group were randomly selected for a resting-state fMRI examination.The treatment schedule lasted for 8 weeks.VAS score, frequency of the migraine attack, number of days with migraine, and HIT-6 score were employed to evaluate the efficacy of acupuncture treatment, and ReHo value was used to detect brain activity.Results: The decrease in the VAS score in the active acupoint group was significantly greater than that in the control group after treatment(P0.05).However, there were no significant differences between the two groups in others(P0.05).The neuroimaging data indicated that long-term active acupoint therapy elicited a more extensive and remarkable cerebral response compared with acupuncture at inactive acupoints.The decrease in the VAS score was significantly related to the increased average ReHo values in the ACC in the two groups(P=0.0020, P=0.0015).Moreover, the decrease in the VAS score was associated with the increased average ReHo values in the insula(P=0.0003), and SMA(P=0.0130), which could be detected in the active acupoint group.Conclusion: Active acupoints were significantly superior to inactive acupoints in alleviating pain intensity for migraineurs.The efficacy of acupuncture at active acupoints might result partly from regulating some disease-affected key regions and the pain circuitry for migraine, promoting reintegration of several dimensions of the inner body, and establishing psychophysical pain homeostasis.     

Acupuncture for migraine:A systematic review and meta-analysis

Objective: The goal of this study is to systematically assess the effectiveness of acupuncture compared with medication for migraine.Methods: The Cochrane Library, PubMed, MEDLINE, Embase, China National Knowledge Infrastructure(CNKI), Sinomed, the Chongqing VIP full-text periodical database(VIP) and Wanfang were searched by computer to identify the randomized controlled trails comparing acupuncture with medication for migraine from the beginning of these databases to August 2018, supplementing with literature retrospective and manual searches. Review Manager 5.2 was used for statistical analysis.Results: A total of 13 trails including 1218 participants met the selection criteria.(1) The meta-analysis of 3 articles showed that acupuncture was more effective in reducing the frequency of migraine attacks(MD =-2.03; 95% CI:-2.77 to-1.30; P 0.00001) than medication.(2) The meta-analysis of three articles showed that acupuncture was more effective in reducing the number of migraine days(MD =-1.65;95% CI:-2.78 to-0.52; P= 0.004) than medication after treatment.(3) The meta-analysis of six articles showed that acupuncture was more effective in reducing VAS(MD =-1.26; 95% CI:-1.48 to-1.04;P 0.00001) after treatment.(4) The meta-analysis of two articles showed that acupuncture was more effective in reducing VAS(MD =-1.07; 95% Cl:-1.63 to-0.51; P= 0.0002) during follow-up.(5) The meta-analysis of seven articles showed that the total effective rate of acupuncture was higher than that of medication(MD=1.27; 95% Cl: 1.16 to 1.37; P 0.00001). In addition, fewer adverse effects in acupuncture groups were reported than in medication groups. Overall the quality of the evidence was low.Conclusion: The results of this meta-analysis showed that acupuncture is more effective and safer than medication for migraine. Acupuncture can be considered a treatment option for patients willing to undergo this treatment. But more high-quality studies, based on standardized, comprehensive and objective evaluation, are required to enhance the reliability of the conclusion.     

灵龟八法针刺治疗风邪袭络型偏头痛疗效观察

目的观察灵龟八法针刺治疗风邪袭络型偏头痛的临床疗效。方法将60例风邪袭络型偏头痛患者随机分为治疗组和对照组,每组30例。治疗组采用灵龟八法针刺治疗,对照组采用常规辨证取穴治疗。两组均在治疗3个疗程后进行疗效比较。结果治疗组总有效率为96.7%,对照组为80.0%,两组比较差异具有统计学意义(P<0.05)。结论灵龟八法针刺是一种治疗风邪袭络型偏头痛的有效方法。     

接气通经针法治疗无先兆性偏头痛疗效观察

目的观察接气通经针法治疗无先兆性偏头痛的临床疗效。方法将符合条件的偏头痛患者随机分为2组,各50例,治疗组采用接气通经针法治疗,对照组采用口服西比灵治疗,分别于治疗前及治疗后7 d观察止痛效果及脑血流变化。结果治疗组止痛有效率显著优于对照组（P〈0.01）,脑血流变化优于对照组（P〈0.05）。结论接气通经针法是治疗无先兆性偏头痛的有效方法。     

接气通经针法治疗无先兆性偏头痛疗效观察

目的观察接气通经针法治疗无先兆性偏头痛的临床疗效。方法将符合条件的偏头痛患者随机分为2组,各50例,治疗组采用接气通经针法治疗,对照组采用口服西比灵治疗,分别于治疗前及治疗后7 d观察止痛效果及脑血流变化。结果治疗组止痛有效率显著优于对照组(P<0.01),脑血流变化优于对照组(P<0.05)。结论接气通经针法是治疗无先兆性偏头痛的有效方法。     

分析针灸配合中药在临床中治疗偏头痛患者的效果

目的:在临床中对偏头痛进行治疗时采用针灸配合中药的方案,分析其应用效果。方法:本研究于2017年11月-2018年11月抽取我院收治的偏头痛患者100例,应用简单随机分配的方法对其进行分组,包含对照组和研究组,对照组接受常规西药治疗,研究组则进行针灸配合中药治疗,比较两组治疗效果、疼痛改善情况、脑部血流速度改善情况以及生活质量改善情况。结果:研究组治疗效果、疼痛改善情况以及生活质量改善情况、脑部血流速度改善情况等均要优于对照组,P<0.05。结论:对偏头痛进行治疗可以采取针灸配合中药的方式,有利于对偏头痛引发的临床症状进行缓解,使患者的生活质量得到明显改善,有效控制病情,降低复发率和偏头痛发作频率。     

Is acupuncture an useful tool for pain-treatment in ophthalmology?

Pain that does not respond to conventional treatment procedures makes it necessary to look for alternative methods. Acupuncture is an ancient procedure with empirical effects on pain. Previous studies established the increased output of messengers at neuronal junctions in spinal cord and hypothalamic locations, especially of endorphins which inhibit the perception of pain. We treated several painful symptoms with acupuncture and evaluated the outcome of the treatment. Patients with various kinds of therapy-refractory pain and patients in whom conventional treatment methods could not be applied were included in the study. The diagnoses included glaucoma. Tolosa-Hunt-Syndrome, ophthalmic migraine, blepharospasm, and dry eyes. In one case acupuncture was used for analgesia during surgery. Acupuncture was performed with sterile disposable needles, at points known to have an empirical analgesic effect. The stimulation was adapted to the patient's individual needs. VAS assessments before and after acupuncture were compared. The t-test was used for statistical evaluation. Acupuncture had no side effects, but reduced pain to a variable extent. Especially in cases of severe pain and in surgery, very effective pain reduction was achieved. In general, pain was significantly reduced in all patients by the use of acupuncture. A statistically significant effect was noted (p < 0.05). Further studies should be conducted to demonstrate the specific effect in larger patient populations. Monitoring neurotransmitter activity will possibly help to illustrate the effect.     

芒针深刺阿是穴治疗中风后肩痛临床观察

目的观察芒针深刺阿是穴治疗中风后肩痛的临床疗效及安全性。方法将60例患者随机分入治疗组和对照组,分别给予芒针深刺阿是穴及毫针针刺"肩三针"治疗,治疗前后采用视觉模拟评分(VAS)、肩痛频度评估疼痛程度,修订的Barthel指数(MBI)评估日常生活能力,治疗结束后评价两组患者治疗满意度。结果依据VAS评价,治疗组总有效率为80.0%,对照组为43.3%,两组疗效比较差异有统计学意义(P<0.01);治疗后两组VAS评分、MBI评分较治疗前均明显改善(P<0.01),组间VAS评分比较差异有统计学意义(P<0.01),而组间MBI评分比较差异无统计学意义(P>0.05);治疗组治疗前后肩痛频度评分差异有统计学意义(P<0.01),而对照组无统计学意义(P>0.05)。结论芒针深刺阿是穴可明显减低中风后肩痛患者的疼痛程度、频度,提高日常生活能力。     

针刺肝胆经穴治疗偏头痛:多中心随机对照研究

目的:评价针刺肝胆经腧穴治疗偏头痛的临床疗效.方法:采用多中心、随机、对照的方法,将253例偏头痛患者随机分为针刺组和西药组;针刺组以针刺肝胆经腧穴治疗,穴取太冲、阳陵泉、风池、曲泉为主;西药组采用盐酸氟桂利嗪(西比灵)片剂口服治疗,共4个疗程.观察两组治疗后3月和6月总体疗效和治疗前后头痛积分,1年后随访观察两组疗效稳定性.结果:两组治疗后头痛平均发作次数和平均持续时间均较治疗前明显改善(均P<0.01),治疗后两组比较,针刺组改善程度优于西药组(均P<0.05).针刺组治疗后和治疗后3个月、6个月止痛总有效率分别为93.0%、93.0%、87.7%,优于西药组的85.6%、86.5%、69.2 9/6(均P<0.01);1年后疗效稳定性针刺组明显优于西药组(P<0.05).结论:针刺肝胆经穴治疗偏头痛是安全、有效的,且远期疗效稳定.     

温针灸治疗虚寒型膝骨关节炎疗效观察

目的：对比温针灸与单纯针刺治疗膝骨关节炎的临床疗效。方法：120例符合膝骨关节炎诊断标准，中医辨证为肾阳虚寒证的患者，随机分为温针灸组和单纯针刺组，两组均取关元、气海、足三里等穴，用关节疼痛量表、膝骨关节炎病情严重性指数量表、采证辨证因子等级评分作为疗效评定标准，评价两种疗法的疗效。结果：温针灸和针刺疗法均能缓解膝骨关节炎的疼痛，改善膝关节的功能障碍，减轻症状，温针灸疗法的临床基本痊愈率为32．1％，总有效率96．4％，优于单纯针刺组的7．4％、92．6％。结论：温针灸是治疗肾阳虚采型膝骨关节炎的有效疗法。     

以痛为腧针刺联合中药敷贴法治疗癌性疼痛的疗效观察

目的：对针刺联合中药敷贴法治疗癌性疼痛进行临床评价。方法：将60例中重度癌性疼痛（中医辨证属瘀血停滞型）的患者,随机分为治疗组（30例）和对照组（30例）。治疗组采用针刺联合中药敷贴,并根据疼痛强度变化,给予适量吗啡滴定;对照组按照“三阶梯药物止痛法”使用镇痛药物。两组均治疗7d。结果：治疗组临床治愈6例,显效11例,有效12例,无效1例,总有效率96．7％;对照组临床治愈4例,显效15例,有效8例,无效3例,总有效率90．0％。两组疗效比较有显著性差异（P〈0．05）。治疗后两组爆发痛次数、疼痛评分、等效吗啡耗量比较,治疗组均优于对照组（P〈0．05）。结论：针剌联合中药敷贴法治疗癌性疼痛疗效显著,优于“三阶梯药物止痛法”。     

针刺治疗偏头痛的神经影像学研究进展＊

偏头痛是一种以搏动性头痛为主要临床特征的神经系统疾病，极大地影响了患者的生活质量，有研究证实，针刺治疗偏头痛安全有效，但起效机制仍然不明确。研究针刺治疗偏头痛的机制，有助于推广针刺治疗偏头痛的适用。过去几年里，神经影像学的发展能够帮助人们深入的理解偏头痛的发病机制。同时，越来越多的针刺治疗偏头痛的神经影像机制研究促进了对针刺起效机制的理解。总的来说，24项针刺治疗偏头痛的神经影像学机制研究发现，针刺可以通过影响脑结构、脑代谢、以及脑功能起到治疗效果。因此，大脑功能结构的改变可能是针刺治疗偏头痛的中枢机制。在这个综述中，我们对当前偏头痛发病的神经影像学机制和针刺治疗的神经影像学机制进行了系统的整理，讨论了针刺治疗偏头痛神经影像学机制的发展方向与展望。     

针刺预防治疗偏头痛59例临床疗效观察

[目的]观察针刺治疗偏头痛的预防治疗疗效。[方法]演针刺主穴率谷、头维、太阳、风池,并辨证选穴治疗偏头痛60例,所有的观察对象均在治疗前、治疗后3个月和治疗后6个月时分别进行偏头痛失能评价(MIDAS)测评,以观察治疗前后各时间段患者偏头痛疼痛程度的变化。[结果]治疗后3个月与治疗后6个月比治疗前MIDAS评价均有改善,差异有极显著性意义(P<0.01);治疗后6个月与治疗后3个月比较,差异无显著性意义(P>0.05)。[结论]治疗后3个月与6个月症状改善明显,6个月与3个月相比没有明显差别。针刺对偏头痛具有较好的预防治疗作用。     

Minimal Acupuncture is not a Valid Placebo Control in Randomised Controlled Trials of Acupuncture: A Physiologist's Perspective

Placebo-control of acupuncture is used to evaluate and distinguish between the specific effects and the non-specific ones. During ,true' acupuncture treatment in general, the needles are inserted into acupoints and stimulated until deqi is evoked. In contrast, during placebo acupuncture, the needles are inserted into non-acupoints and/or superficially (so-called minimal acupuncture). A sham acupuncture needle with a blunt tip may be used in placebo acupuncture. Both minimal acupuncture and the placebo acupuncture with the sham acupuncture needle touching the skin would evoke activity in cutaneous afferent nerves. This afferent nerve activity has pronounced effects on the functional connectivity in the brain resulting in a ,limbic touch response'. Clinical studies showed that both acupuncture and minimal acupuncture procedures induced significant alleviation of migraine and that both procedures were equally effective. In other conditions such as low back pain and knee osteoarthritis, acupuncture was found to be more potent than minimal acupuncture and conventional non-acupuncture treatment. It is probable that the responses to ,true' acupuncture and minimal acupuncture are dependent on the aetiology of the pain. Furthermore, patients and healthy individuals may have different responses. In this paper, we argue that minimal acupuncture is not valid as an inert placebo-control despite its conceptual brilliance.     

针刺预防性治疗对无先兆偏头痛患者生存质量的影响

目的:评价针刺预防性治疗偏头痛的疗效及对患者生存质量的影响.方法:采用随机对照、双盲、双模拟的研究方法,将60例患者随机分为观察组(30例)和对照组(30例).观察组采用针刺结合口服盐酸氟桂利嗪空白胶囊治疗,穴取百会、神庭、本神为主;对照组采用口服盐酸氟桂利嗪胶囊结合针刺安慰穴治疗,每周治疗3次,连续治疗4周.分别于治疗前、后及治疗后3个月,采用SF-36生存质量量表评分及有效率进行疗效评价.结果:两组患者SF-36各维度评分在3个时间点上差异有统计学意义(均P＜0.05).治疗后生理职能维度观察组优于对照组(P＜0.05),其余7个维度两组间差异无统计学意义(均P＞0.05).治疗后及治疗后3个月,观察组有效率分别为68.0%、68.0%,均优于对照组的24.0 9/6、32.0%(均P＜0.05).结论:针刺预防性治疗能够有效地提高偏头痛患者生存质量并减少头痛发作.针刺与盐酸氟桂利嗪在改善偏头痛患者躯体健康及精神健康方面无明显差异,在减少偏头痛发作天数上针刺更为有效.     

头痛宁胶囊合针刺防治偏头痛60例

目的:观察头痛宁胶囊合针刺防治偏头痛的疗效.方法:将118例门诊偏头痛患者随机分为对照组58例和治疗组60例,对照组采用西比灵配合丹参滴丸口服治疗,治疗组采用头痛宁胶囊合针刺治疗,2组均以30天为1个疗程.治疗前后观察2组在头痛持续时间、发作频率、头痛强度等方面的改善情况,并比较疗效.结果:经过1个疗程的治疗,总有效率...     

风池穴为主治疗偏头痛临床研究进展

通过查阅近五年内使用针刺、艾灸、电针、穴位注射、穴位埋线、小针刀、推拿等方法治疗偏头痛的相关文献,归纳单用风池穴或辨证配合风池穴治疗偏头痛的临床研究进展.目前选取风池穴治疗偏头痛已在临床上得到广泛应用,其具体临床操作以针刺为主,同时配合电针、耳穴、穴位注射等方法,疗效确切,值得进一步推广应用.     

针灸疗法治疗偏头痛研究进展

针灸治疗偏头痛历史悠久，具有操作便捷、疗效显著的特点，以针灸为主的综合治疗方法在偏头痛的防治中应用越来越多，对于不适合药物治疗的偏头痛患者发挥了重要作用。本文通过对近年来针灸治疗偏头痛的文献进行整理，总结了偏头痛发生的病因病机，并从常用针灸取穴、常用针灸疗法等方面论述针灸治疗偏头痛的研究现状，结果发现针刺取穴以手足少阳经腧穴为主，针刺疗法包括毫针、电针、眼针、头针等，都具有明显的疗效。