Hu Jinglin, Wang Xichen, Jia Siqi, Kong Lingzu, Wang Yining, Xin Xiaoqi, Hu Yinghua, Chen Xinhua
College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, China.
School of Medical Information, Changchun University of Chinese Medicine, Changchun, Jilin, China.
Front Neurol. 2023 Jun 22;14:1194441. doi: 10.3389/fneur.2023.1194441. eCollection 2023.
Tension-type headache (TTH) is one of the most common primary headaches. Several studies have confirmed the efficacy of acupuncture therapies for TTH, but it is uncertain which treatment is most effective.
This study aimed to compare the effectiveness and safety of different acupuncture therapies for TTH using Bayesian Network Meta-analysis to provide new ideas for treating TTH.
Nine databases were searched for randomized controlled trials (RCTs) about different acupuncture therapies for TTH up to December 1, 2022. The outcome indicators analyzed in our study were total effective rate, visual analog scale (VAS), headache frequency, and safety. Pairwise meta-analysis and risk of bias assessment were performed using Review Manager 5.4. Stata 15.0 generated a network evidence plot and detected publication bias. Finally, a Bayesian network meta-analysis of the data was used by RStudio.
The screening process resulted in 30 RCTs that met the inclusion criteria, including 2,722 patients. Most studies failed to report details of trials and were therefore assessed as unclear risks. Two studies were considered high risk because they did not report on all pre-specified outcome indicators or had incomplete data on outcome indicators. The NMA results showed that for total effective rate, bloodletting therapy had the most considerable SUCRA value (0.93156136), for VAS, head acupuncture combined with Western medicine ranked first (SUCRA = 0.89523571), and acupuncture combined with herbal medicine was the most effective in improving headache frequency ( > 0.05).
Acupuncture can be used as one of the complementary or alternative therapies for TTH; bloodletting therapy better improves the overall symptoms of TTH, head acupuncture combined with Western medicine is more effective in reducing VAS scores, and acupuncture combined with herbal medicine seems to reduce headache frequency, but the difference is not statistically significant. Overall, acupuncture for TTH is effective with mild side effects, but future high-quality studies are still necessary.
https://www.crd.york.ac.uk/prospero/, PROSPERO [CRD42022368749].
紧张型头痛（TTH）是最常见的原发性头痛之一。多项研究已证实针刺疗法对紧张型头痛的疗效，但哪种治疗方法最有效尚不确定。
本研究旨在通过贝叶斯网络Meta分析比较不同针刺疗法治疗紧张型头痛的有效性和安全性，为紧张型头痛的治疗提供新思路。
检索9个数据库，查找截至2022年12月1日关于不同针刺疗法治疗紧张型头痛的随机对照试验（RCT）。本研究分析的结局指标为总有效率、视觉模拟评分（VAS）、头痛频率和安全性。使用Review Manager 5.4进行成对Meta分析和偏倚风险评估。Stata 15.0生成网络证据图并检测发表偏倚。最后，使用RStudio对数据进行贝叶斯网络Meta分析。
筛选过程产生了30项符合纳入标准的RCT，包括2722例患者。大多数研究未报告试验细节，因此被评估为风险不明确。两项研究被认为风险高，因为它们未报告所有预先指定的结局指标或结局指标数据不完整。NMA结果显示，对于总有效率，放血疗法的SUCRA值最高（0.93156136）；对于VAS，头针结合西药排名第一（SUCRA = 0.89523571）；针刺结合草药在改善头痛频率方面最有效（>0.05）。
针刺可作为紧张型头痛的补充或替代疗法之一；放血疗法能更好地改善紧张型头痛的整体症状，头针结合西药在降低VAS评分方面更有效，针刺结合草药似乎能降低头痛频率，但差异无统计学意义。总体而言，针刺治疗紧张型头痛有效，副作用轻微，但仍需要未来高质量的研究。
https://www.crd.york.ac.uk/prospero/，PROSPERO [CRD42022368749]
