Sun Yanxia, Gan Tong J
Duke University Medical Center, Department of Anesthesiology, Box 3094, Durham, NC 27710, USA.
Anesth Analg. 2008 Dec;107(6):2038-47. doi: 10.1213/ane.0b013e318187c76a.
The objective of this review was to evaluate the efficacy of acupuncture for treatment of chronic headache.
We searched the databases of Medline (1966-2007), CINAHL, The Cochrane Central Register of Controlled Trials (2006), and Scopus for randomized controlled trials investigating the use of acupuncture for chronic headache. Studies were included in which adults with chronic headache, including migraine, tension-type headache or both, were randomized to receive needling acupuncture treatment or control consisting of sham acupuncture, medication therapy, and other nonpharmacological treatments. We extracted the data on headache intensity, headache frequency, and response rate assessed at early and late follow-up periods.
Thirty-one studies were included in this review. The majority of included trials comparing true acupuncture and sham acupuncture showed a trend in favor of acupuncture. The combined response rate in the acupuncture group was significantly higher compared with sham acupuncture either at the early follow-up period (risk ratio [RR]: 1.19, 95% confidence interval [CI]: 1.08, 1.30) or late follow-up period (RR: 1.22, 95% CI: 1.04, 1.43). Combined data also showed acupuncture was superior to medication therapy for headache intensity (weighted mean difference: -8.54 mm, 95% CI: -15.52, -1.57), headache frequency (standard mean difference: -0.70, 95% CI: -1.38, -0.02), physical function (weighted mean difference: 4.16, 95% CI: 1.33, 6.98), and response rate (RR: 1.49, 95% CI: 1.02, 2.17).
Needling acupuncture is superior to sham acupuncture and medication therapy in improving headache intensity, frequency, and response rate.
本综述的目的是评估针刺治疗慢性头痛的疗效。
我们检索了Medline（1966 - 2007年）、CINAHL、Cochrane对照试验中央注册库（2006年）和Scopus数据库，以查找研究针刺治疗慢性头痛的随机对照试验。纳入的研究中，患有慢性头痛（包括偏头痛、紧张型头痛或两者皆有）的成年人被随机分配接受针刺治疗或对照，对照包括假针刺、药物治疗和其他非药物治疗。我们提取了在早期和晚期随访期评估的头痛强度、头痛频率和缓解率的数据。
本综述纳入了31项研究。大多数比较真针刺和假针刺的纳入试验显示出有利于针刺的趋势。针刺组的综合缓解率在早期随访期（风险比[RR]：1.19，95%置信区间[CI]：1.08，1.30）或晚期随访期（RR：1.22，95%CI：1.04，1.43）均显著高于假针刺。综合数据还显示，针刺在头痛强度（加权平均差：-8.54 mm，95%CI：-15.52，-1.57）、头痛频率（标准化平均差：-0.70，95%CI：-1.38，-0.02）、身体功能（加权平均差：4.16，95%CI：1.33，6.98）和缓解率（RR：1.49，95%CI：1.02，2.17）方面优于药物治疗。
针刺在改善头痛强度、频率和缓解率方面优于假针刺和药物治疗。
