Pistoia Francesca, Cesarano Simone, Saporito Gennaro, Albanese Maria, Lucenti Cecilia, Scarsella Secondo, Liguori Aldo, Ronchi Federica Umani
Department of Biotechnological and Applied Clinical Sciences, University of L'aquila, L'Aquila, Italy.
Regional Referral Headache Center, San Salvatore Hospital, L'Aquila, Italy.
Eur J Neurol. 2025 Apr;32(4):e70160. doi: 10.1111/ene.70160.
Although innovative pharmacological therapies for migraine prevention are now available, they may not be suitable or effective for all patients due to concerns about tolerability and the varying complexity of the underlying condition. This study systematically reviewed and meta-analyzed acupuncture's effects on migraine prophylaxis compared to standard medical care, focusing on study heterogeneity and issues related to sham interventions.
Following the PRISMA guidelines and using the PICO model, the study searched PubMed, Scopus, CNKI, and VIP database from December 1965 to September 2024. Studies evaluating acupuncture's clinical efficacy for migraine prophylaxis, including clinical trials, observational studies, case series, and case reports, were considered. An additional search was conducted on the clinicaltrials.gov database from the beginning of indexing up to September 2024 to include ongoing studies. Quality control and bias assessment were performed. Primary outcomes focused on acupuncture's efficacy and safety versus pharmacological treatments in reducing migraine frequency and intensity. The impact on patients' quality of life was also evaluated.
At the end of the selection process, 15 studies were eligible. Acupuncture showed no statistically significant difference as a prophylactic treatment for migraine in reducing the frequency of migraine days or pain intensity but did reduce the use of analgesics while improving patients' quality of life.
Current evidence supports acupuncture as an adjunctive therapy in migraine prophylaxis, but challenges such as protocol heterogeneity, dropout biases, the complexities of sham-controlled trials, and the lack of comparison data with newer innovative treatments not yet considered warrant further research.
尽管目前已有用于预防偏头痛的创新药物疗法，但由于耐受性问题以及潜在病情的复杂性各异，这些疗法可能并不适用于所有患者或对其都有效。本研究系统评价并荟萃分析了与标准医疗护理相比，针灸对偏头痛预防的效果，重点关注研究的异质性以及与假干预相关的问题。
本研究遵循PRISMA指南并使用PICO模型，检索了1965年12月至2024年9月期间的PubMed、Scopus、中国知网和维普数据库。纳入评估针灸预防偏头痛临床疗效的研究，包括临床试验、观察性研究、病例系列和病例报告。还对clinicaltrials.gov数据库从开始收录至2024年9月进行了额外检索，以纳入正在进行的研究。进行了质量控制和偏倚评估。主要结局指标聚焦于针灸与药物治疗相比在降低偏头痛发作频率和强度方面的疗效和安全性。还评估了对患者生活质量的影响。
在筛选过程结束时，有15项研究符合条件。作为偏头痛的预防性治疗，针灸在减少偏头痛天数频率或疼痛强度方面没有显示出统计学上的显著差异，但确实减少了镇痛药的使用，同时改善了患者的生活质量。
目前的证据支持针灸作为偏头痛预防的辅助疗法，但诸如方案异质性、失访偏倚、假对照试验的复杂性以及缺乏与尚未考虑的新型创新治疗方法的比较数据等挑战，仍需要进一步研究。
