Institution of Clinical Research and Evidence-Based Medicine, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China.
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China; Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
J Integr Med. 2022 May;20(3):213-220. doi: 10.1016/j.joim.2022.02.003. Epub 2022 Feb 4.
Acupuncture has been widely used to relieve migraine-related symptoms. However, the findings of previous systematic reviews (SRs) and meta-analyses (MAs) are still not completely consistent. Their quality is also unknown, so a comprehensive study is needed.
To evaluate the reporting and methodological quality of these MAs concerning acupuncture for migraine, and summarize evidence about the efficacy and safety of acupuncture for migraine.
PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Databases, Wanfang Data, and VIP databases were searched from inception to September 2020, with a comprehensive search strategy.
The pairwise MAs of randomized controlled trials (RCTs) concerning migraine treated by acupuncture or acupuncture-based therapies, with a control group that received sham acupuncture, medication, no treatment, or acupuncture at different acupoints were included.
Two independent investigators screened studies, extracted relevant data, and assessed reporting and methodological quality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 and A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), then all results were cross-checked. Spearman correlation test was used to evaluate the correlation between reporting and methodological quality scores.
A total of 20 MAs were included in this study. The included MAs indicated that acupuncture was efficacious and safe in preventing and treating migraine when compared with control intervention. There was a high correlation between reporting and methodological quality scores (r = 0.87, P < 0.001). The quality of the included SRs needs to be improved mainly with regard to protocol and prospective registration, using a comprehensive search strategy, summarizing the strength of evidence body for key outcomes, a full list of excluded studies with reasons for exclusion, reporting of RCTs' funding sources, and assessing the potential impact of risk of bias in RCTs on MA results.
Acupuncture is an effective and safe intervention for preventing and treating migraine, and could be considered as a good option for patients with migraine. However, the reporting and methodological quality of MAs included in this overview is suboptimal. In the future, AMSTAR 2 and PRISMA tools should be followed when making and reporting an SR with MA.
针灸已广泛用于缓解偏头痛相关症状。然而，先前的系统评价（SRs）和荟萃分析（MAs）的结果仍然不完全一致。其质量也不清楚，因此需要进行全面的研究。
评估这些关于针灸治疗偏头痛的 MAs 的报告和方法学质量，并总结针灸治疗偏头痛的疗效和安全性证据。
从建库至 2020 年 9 月，检索了 PubMed、Embase、Cochrane 图书馆、中国知网、中国生物医学文献数据库、万方数据知识服务平台和维普数据库，制定了全面的检索策略。
纳入了针灸或基于针灸的疗法治疗偏头痛的随机对照试验（RCTs）的成对 MAs，对照组接受假针灸、药物、无治疗或不同穴位的针灸。
两名独立的研究者筛选研究、提取相关数据，并使用系统评价和荟萃分析的 Preferred Reporting Items（PRISMA）2009 和评估系统评价的工具（AMSTAR 2）评估报告和方法学质量，然后对所有结果进行交叉核对。使用 Spearman 相关检验评估报告和方法学质量评分之间的相关性。
本研究共纳入 20 项 MAs。纳入的 MAs 表明，与对照干预相比，针灸在预防和治疗偏头痛方面是有效和安全的。报告和方法学质量评分之间存在高度相关性（r=0.87，P<0.001）。纳入的 SR 的质量需要改进，主要是关于方案和前瞻性注册、使用全面的检索策略、总结关键结局的证据体强度、列出完整的排除研究清单及其排除原因、报告 RCT 的资金来源以及评估 RCT 偏倚风险对 MA 结果的潜在影响。
针灸是预防和治疗偏头痛的有效和安全干预措施，可作为偏头痛患者的一种较好选择。然而，本综述中纳入的 MAs 的报告和方法学质量较差。未来在进行包含 MA 的 SR 时，应遵循 AMSTAR 2 和 PRISMA 工具。
