Weinschütz T
Klinik für Neurologie, Christian-Albrechts-Universität, Niemannsweg 147, D-24105 Kiel.
Schmerz. 1996 Jun 17;10(3):149-55. doi: 10.1007/s004829600044.
Acupuncture is now being increasingly used in the treatment of headache. Acupuncture is a technique originating in Asia, from countries that have a cultural background with a fundamentally different concept of disease and therapy. Up to now, sustained application of acupuncture in Western medicine has been impeded by the lack of a scientifically convincing explanation of the mechanisms of action in terms of neurobiological criteria. Acupuncture is being used empirically in the treatment of migraine; clinical studies have been published. A definitive evaluation of acupuncture based on well-founded clinical experimental studies has yet to be made. The investigation was carried out in migraine patients who were divided into two subgroups in a control group design with two different stimulation techniques. The verum group was treated with the correct point location, normal prick depth and elicitation of a needle sensation. The control group received treatment at points that are far away from the acupuncture points, using a superficial prick technique and without eliciting a needle sensation. The effect of therapy was appraised by means of headache diaries with subsequent interference statistical and individual case analysis. In the present study comprising 81 patients, the incidence of the attacks was significantly reduced in both subgroups. The effect of acupuncture treatment was of comparable magnitude to that of the beta-blocker metoprolol. The advantage of acupuncture treatment consists in the lack of side effects such as gastrointestinal symptoms or an increase in weight. A minor side effect was only reported in one case. In the data analysis with the interference statistical method, verum acupuncture was superior to the control in only one subgroup. The possibility that the addition of further points (distant points) can explain this effect on the basis of the hypothesis of a central modulation of the migraine process is discussed. Acupuncture shows a sufficiently pronounced and sustained therapeutic effect for its use to be considered in a possible interval treatment of migraine.
针灸目前在头痛治疗中的应用越来越广泛。针灸是一种起源于亚洲的技术，来自那些在疾病和治疗观念上有着根本不同文化背景的国家。到目前为止，由于缺乏从神经生物学标准对其作用机制进行科学可信的解释，针灸在西医中的持续应用受到了阻碍。针灸已被经验性地用于偏头痛治疗；相关临床研究已经发表。基于充分可靠的临床实验研究对针灸进行的最终评估尚未完成。该研究针对偏头痛患者进行，在一种采用两种不同刺激技术的对照分组设计中，将患者分为两个亚组。治疗组采用正确的穴位定位、正常的针刺深度并诱发针感进行治疗。对照组在远离穴位的部位进行治疗，采用浅刺技术且不诱发针感。通过头痛日记并随后进行干扰统计和个案分析来评估治疗效果。在本项包含81名患者的研究中，两个亚组的发作次数均显著减少。针灸治疗的效果与β受体阻滞剂美托洛尔相当。针灸治疗的优势在于没有诸如胃肠道症状或体重增加等副作用。仅1例报告有轻微副作用。在采用干扰统计方法的数据分析中，治疗组针灸仅在一个亚组中优于对照组。讨论了基于偏头痛过程的中枢调节假说，增加更多穴位（远端穴位）能否解释这种效果的可能性。针灸显示出足够显著且持续的治疗效果，因此在偏头痛的可能间歇治疗中可考虑使用。
