Clinical study of the efficacy of treating migraines with acupuncture

Zhao et al. 2017
https://pubmed.ncbi.nlm.nih.gov/28241154/

The Zhao et al. trial conducted an random control trial (RCT) comparing verum (hereafter designated “true”, or traditional Chinese medicine/TCM) acupuncture, sham acupuncture, and a waiting-list control group. The study recruited 249 patients who experience migraines without auras. Participants were randomly assigned to receive only true acupuncture, or sham acupuncture, or put into a third group that would receive no acupuncture through the course of the study but were promised acupuncture sessions following the conclusion of the study.

The true and sham acupuncture groups received 20 sessions of 30 minutes of electro-acupuncture over the course of 4 weeks. Sessions were conducted once a day for 5 days consecutively, with 2 days without acupuncture every week. Patients were not allowed to take any prophylactic medication; in the case that medication was necessary for severe incidence of headache, patients were instructed to take ibuprofen and to document it in the headache diary. The control group received no acupuncture.

In the true acupuncture group, four acu-points (needled unilaterally, on alternating sides, therefore 4 needles only) were used: two obligatory local points : GB20 and GB8; and two additional points based on the individual’s TCM diagnosis. Points were selected from the following: SJ5 GB34 BL60 SI3 LI4 ST44 LV3 GB40.

De qi (the Qi sensation felt by the patient) was achieved and the HANS acupoint nerve stimulator (a TENS machine, model LH200A) was applied, with a frequency of 2/100 Hz, alternating every 3 seconds, with an intensity of 0.1- 1.0 mA.

In the sham acupuncture group, the number of needles, electro-stimulation, and duration of treatment was the same as that given to the true acupuncture group. However, De qi sensation was avoided and only non-TCM points were selected for needling.

Patients completed headache diaries every 4 weeks. Diaries documented the time of onset, duration, severity, and any acute medication use.

The primary outcome measured the change in frequency of migraine attacks between baseline (before the initiation of the study) and 16 weeks after randomisation of the groups. The secondary outcome measured the number of migraine days, severity, and medication taken every 4 weeks within 24 weeks. A quality of life questionnaire (MSQ) and pain related impairment of emotion scales (SAS and SDS) were assessed at baseline and every 4 weeks.

At 16 weeks the frequency of migraines among the three groups significantly differed. The frequency of headaches in the true acupuncture group decreased by 3.2, in the sham acupuncture group by 2.1, and in the waiting-list group by 1.4 attacks.

The secondary outcomes recorded that the number of migraine days were lower in the true acupuncture group than the sham or waiting-list control groups. After 4 weeks, the results from the quality of life questionnaire, SAS, and SDS showed a significant difference between the true acupuncture group and the waiting-list control group, and a slight difference between the true and sham acupuncture groups. The use of acute medication also differed amongst the 3 groups. The use of medication in the sham and true acupuncture groups was reduced as compared with the waitlist group.

The results suggest that true acupuncture was more effective than sham acupuncture, or no acupuncture at all, in reducing the frequency and number of days of migraines. However, congruent with other studies, the sham acupuncture group fared better than the waiting-list control group, suggesting that there is a beneficial analgesic effect to acupuncture.

Other studies on the treatment of migraines using acupuncture can be explored here via clickable links:
1. Linde et al., 2005. “Acupuncture for Patients With Migraine, A Randomized Control Trial”
2. Deiner et al., 2006. “Efficacy of Acupuncture for the Prophylaxis of Migraine: a Multicentre Randomised Controlled Clinical Trial”
3. Li et al., 2012 “Acupuncture for Migraine Prophylaxis: a Randomized Control Trial”

Authored by Emily Cronin, 2019.