Zhen Ci Yan Jiu. 2013 Jun;38(3):234-40.
[Optimized schemes for acupuncture treatment of migraine during attack].
[Article in Chinese]
Wang JJ, Wu ZC, Hu J, Jiao Y, Zheng JY, Wang QM.
Source
Institute of Acu-moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China. wjj751@sina.com
Abstract
OBJECTIVE:
To observe the therapeutic effect of manual acupuncture, electroacupuncture (EA), auricular acupuncture and bloodletting therapies combined with orthogonal design for migraine patients, so as to select a better scheme for relieving headache.
METHODS:
total of 76 migraine patients in the stage of attack were recruited in the present study and randomly (stratified random and central random) allocated to 9 groups by means of orthogonal experimental design [L9 (3(4)), 4 factors (F) and three levels (L)] i.e., F1: ody-acupoints combination; F1-L1: regional acupoints [Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5), etc.] near the focus, F1-L2:regional +distal acupoints [Hegu (L 4), Taichong (LR 3), etc.] far from the focus, and F1-L3:regional + remote acupoints+ those selected according to syndrome differentiation [for instance, Ganshu (BL 18), Yanglingquan (GB 34), Qiuxu (GB 40) and Taixi (KI 3) for hyperactivity of Liver-yang, etc.]; F2: manual acupuncture or EA of body acupoints; F2-L1:no acupuncture stimulation, F2-L2:manual acupuncture stimulation, and F2-L3:manual + EA stimulation; F3: auricular acupuncture therapy; F3-L1:no acupuncture stimulation, F3-L2: otopoint-manual acupuncture (Shenmen, Jiaogan, etc.), and F3-L3:otopoint-EA; F4: bloodletting; F4-L1 : EX-HN 5 + Ashi point bloodletting, F4-L2:EX-HN5 bloodletting, and F4-L3: no bloodletting. The therapeutic effect of acupuncture was evaluated using Visual Analogue Scale (VAS) and analyzed by investigators who did not participate in the treatment course.
RESULTS:
Within 24 hours after the treatment, the four factors influencing headache relief from bigger to smaller are body-acupoints combination > manual acupuncture or EA stimulation > bloodletting > auricular acupuncture. Among the therapeutic schemes evaluated by orthogonal deduction, the analgesic effect was most stable in the manual acupuncture at regional + distal acupoints group which was recommended to be the ba-sic scheme for migraine. The auricular EA could effectively reduce VAS levels from 10 min to 30 min after stimulation, while bloodletting at Taiyang (EX-HN 5)+ Ashi points was effective in relieving migraine from 4 h to 24 h after the treatment, suggesting a long lasting post-therapeutic analgesic effect.
CONCLUSION:
Manual acupuncture stimulation of the local + distal body acupoints combined with otopoint-EA and bloodletting at Taiyang (EX-HN 5) + Ashi points is the best option for relieving migraine during attack.




Neurol Sci. 2014 May;35 Suppl 1:129-33. doi: 10.1007/s10072-014-1754-0.
Effects of the acupoints PC 6 Neiguan and LR 3 Taichong on cerebral blood flow in normal subjects and in migraine patients.
Quirico PE1, Allais G, Ferrando M, de Lorenzo C, Burzio C, Bergandi F, Rolando S, Schiapparelli P, Benedetto C.
Author information


Abstract
Acupuncture has been proven to be effective in the treatment of various cardiovascular disorders; it acts both on the peripheral flow and on the cerebral flow. Our study aimed to evaluate the effects of the insertion of PC 6 Neiguan and LR 3 Taichong acupoints on the cerebral blood flow (CBF) in the middle cerebral artery (MCA). These effects were measured in a group of patients suffering from migraine without aura (Group M) and in a healthy control group (Group C). In the study, we included 16 patients suffering from migraine without aura, classified according to the criteria of the International Headache Society, and 14 healthy subjects as a control group. The subjects took part in the study on two different days, and on each day, the effect of a single acupoint was evaluated. Transcranial Doppler was used to measure the blood flow velocity (BFV) in the MCA. Our study showed that the stimulation of PC 6 Neiguan in both groups results in a significant and longlasting reduction in the average BFV in the MCA. After pricking LR 3 Taichong, instead, the average BFV undergoes a very sudden and marked increase; subsequently, it decreases and tends to stabilize at a slightly higher level compared with the baseline, recorded before needle insertion. Our data seem to suggest that these two acupoints have very different effects on CBF. The insertion of PC 6 Neiguan probably triggers a vasodilation in MCA, while the pricking of LR 3 Taichong determines a rapid and marked vasoconstriction.




Neurol Sci. 2014 May;35 Suppl 1:195-8. doi: 10.1007/s10072-014-1769-6.
Acupuncture in cluster headache: four cases and review of the literature.
Fofi L1, Allais G, Quirico PE, Rolando S, Borgogno P, Barbanti P, Benedetto C.
Author information


Abstract
Although cluster headache (CH) is the most disabling form of primary headache, little evidences regarding alternative and complementary therapies are available. Only few dated studies and some isolated cases are described. We describe four patients with CH treated with acupuncture as a preventive treatment, combined with verapamil or alone. All patients received acupuncture treatment twice/week for 2 weeks, then once/week for 8 weeks, and then once/alternate weeks for 2 weeks. According to Traditional Chinese Medicine the acupoints selected were: Ex HN-5 Taiyang, GB 14 Yangbai (both only on the affected side), GB 20 Fengchi (on both sides), LI 4 Hegu, LR 2 Xingjiang, SP 6 Sanyinjiao, ST 36 Zusanli (all on both sides). At each point, after the insertion of the needle, the feeling of "De Qi" was evoked; after obtaining this sensation the acupoints were not further stimulated for a period of 20 min, until their extraction. In all patients an interruption of cluster attacks was obtained. To our knowledge, this is the first report concerning acupuncture in CH patients which details the protocol approach, acupoints and duration of the treatment. Our results offer the opportunity to discuss the emerging role of acupuncture in the therapy of CH, assuming a possible influence on opioid system.




Acupunct Med. 2014 Aug 27. pii: acupmed-2014-010612. doi: 10.1136/acupmed-2014-010612. [Epub ahead of print]
Acupuncture decreases matrix metalloproteinase-2 activity in patients with migraine.
Cayir Y1, Ozdemir G2, Celik M3, Aksoy H4, Akturk Z1, Laloglu E4, Akcay F5.
Author information


Abstract
OBJECTIVE:
To evaluate the effect of acupuncture on the serum matrix metalloproteinase-2 (MMP-2) level and activity in patients with migraine.
METHODS:
After baseline testing, eligible patients with migraine according to the criteria of the International Headache Society who volunteered to join the study were included (n=27). The patients received 10 sessions of acupuncture treatment. The points selected were bilateral ST8, ST44, LI4, LI11, LIV3, SP6, GB1, GB14, GB20, GV14, GV20, Yintang, Taiyang and ear Shenmen. Pain was measured using a visual analogue scale (VAS). Short form-36 (SF-36) was used to determine their quality of life. Blood samples were taken before treatment and after the first and last sessions of acupuncture for measurement of MMP-2 concentration and activity.
RESULTS:
The mean VAS was 85.5±16.6 before acupuncture and was significantly decreased to 39.8±20.6 after 10 sessions of acupuncture (p<0.0001). There was a significant increase in all SF-36 scores after acupuncture compared with values before treatment (p<0.0001). No significant differences were found in MMP-2 concentrations before treatment and after the first and last sessions (p>0.05). However, there were significant changes in MMP-2 activity (p<0.0001).
CONCLUSIONS:
The results of this study showed a clinically relevant decrease in MMP-2 activity in patients with migraine treated with acupuncture. The mechanism underlying the effect of acupuncture in alleviating pain may be associated with a decrease in MMP-2 activity.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.




Indian J Physiol Pharmacol. 2014 Jan-Mar;58(1):69-76.
Comparison of effectiveness of acupuncture therapy and conventional drug therapy on psychological profile of migraine patients.
Vijayalakshmi I, Shankar N, Saxena A, Bhatia MS.
Abstract
Migraine is a painful condition in which patients suffer from recurrent episodes of disabling pain, which could be very severe and can lead to grave psychological disturbances. There is no curative treatment for migraine, but there are various treatment modalities, though, with conflicting reports on their efficacy. This study was conducted to compare the effectiveness of electro acupuncture therapy and the conventional drug therapy on the psychological profile of migraneurs based on the assessment of quality of life and disability parameters. Migraneurs (n = 60) were recruited from the Psychiatry and Neurology OPD, Guru Tegh Bahadur Hospital, Delhi. Following a written consent, migraneurs were randomly allocated into 2 study groups--Group A received 10 sittings of electro acupuncture on selected acupuncture points over a period of 30 days, while for the same duration the Group D received a conventional drug therapy in the form of oral flunarizine 20 mg OD along with paracetamol 500 mg SOS. The patients were assessed twice, before and after completion of the treatment programme (30 days). The quality of life was assessed with WHOQOL BREF (WHO Quality of Life Biomedical Research and Education Foundation) questionnaire and the disability was assessed with MIDAS (Migraine Disability Assessment) questionnaire. Statistical analysis was performed using repeated measure's ANOVA with Tukey's test. Migraneurs were found to have lower quality of life and higher disability scores but following the treatment regimes, the 2 study groups showed a significant improvement in both the parameters studied. It was however observed, that the acupuncture group showed a better response and was thus found to be more effective as compared to the drug group (P = 0.005 to 0.000). We thus conclude that acupuncture is a better treatment option than the conventional drug therapy in not only relieving the pain of migraine but in also improving the psychological profile in migraneurs. Hence its use should be encouraged as an alternative/adjunct treatment for migraine.




Mil Med. 2015 Feb;180(2):132-136.
Clinical Indications for Acupuncture in Chronic Post-Traumatic Headache Management.
Khusid MA1.
Author information


Abstract
Chronic post-traumatic headache (PTH) is one of the most common complaints after mild traumatic brain injury, yet evidence to date is insufficient to direct conventional treatment of headaches with this etiology. Therefore, the current guidelines recommend a symptomatic approach for the three patterns of PTHs: migraine-like, tension-like, and mixed symptomatology. To improve response rates and minimize the potential for polypharmacy, adverse effects, and risk of dependency, effective nonpharmacologic options should be employed to support faster and safer patient rehabilitation. Current evidence shows that acupuncture is at least as effective as drug therapy for migraine prophylaxis and neurovascular and tension-type headaches. Because of its safety, cost-effectiveness, and long-lasting benefits, adjunctive acupuncture should be offered to patients with chronic PTHs and may be a valuable primary treatment alternative for those with contraindications to pharmacotherapy. Future head-to-head, adequately powered, well-controlled randomized clinical trials are needed to investigate acupuncture efficacy for PTHs.
Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.



J Headache Pain. 2015 Dec;16(1):518. doi: 10.1186/s10194-015-0518-4. Epub 2015 Apr 18.
The effects of acupuncture treatment on the right frontoparietal network in migraine without aura patients.
Li K1, Zhang Y, Ning Y, Zhang H, Liu H, Fu C, Ren Y, Zou Y.
Author information


Abstract
BACKGROUND:
Functional and structural abnormalities in resting-state brain networks in migraine patients have been confirmed by previous functional magnetic resonance imaging (fMRI) studies. However, few studies focusing on the neural responses of therapeutic treatment on migraine have been conducted. In this study, we tried to examined the treatment-related effects of standard acupuncture treatment on the right frontoparietal network (RFPN) in migraine patients.
METHODS:
A total of 12 migraine without aura (MWoA) patients were recruited to undergo resting-state fMRI scanning and were rescanned after 4 weeks standard acupuncture treatment. Another 12 matched healthy control (HC) subjects underwent once scanning for comparison. We analyzed the functional connectivity of the RFPN between MWoA patients and HC subjects before treatment and that of the MWoA patients before and after treatment. Diffusion tensor images (DTI) data analyzing was also performed to detect fiber-related treatment responses.
RESULTS:
We observed significantly decreased FC in the RFPN and that the decreased FC could be reversed by acupuncture treatment. The changes of FC in MWoA patients was negatively correlated with the decrease of visual analogue scale (VAS) scores after treatment. This study indicated that acupuncture treatment for MWoA patients was associated with normalizing effects on the intrinsic decreased FC of the RFPN.
CONCLUSIONS:
Our study provided new insights into the treatment-related neural responses in MWoA patients and suggested potential functional pathways for the evaluation of treatment in MWoA patients. Future studies are still in need to confirm the current results and to elucidate the complex neural mechanisms of acupuncture treatment.


Sao Paulo Med J. 2015 Dec;133(6):540.
Acupuncture for migraine prophylaxis.
Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR.
Abstract
BACKGROUND:
Acupuncture is often used for migraine prophylaxis but its effectiveness is still controversial. This review (along with a companion review on 'Acupuncture for tension-type headache') represents an updated version of a Cochrane review originally published in Issue 1, 2001, of The Cochrane Library.
OBJECTIVES:
To investigate whether acupuncture is a) more effective than no prophylactic treatment/routine care only; b) more effective than 'sham' (placebo) acupuncture; and c) as effective as other interventions in reducing headache frequency in patients with migraine.
METHODS:
Search methods: The Cochrane Pain, Palliative & Supportive Care Trials Register, CENTRAL, MEDLINE, EMBASE and the Cochrane Complementary Medicine Field Trials Register were searched to January 2008.
SELECTION CRITERIA:
We included randomized trials with a post-randomization observation period of at least 8 weeks that compared the clinical effects of an acupuncture intervention with a control (no prophylactic treatment or routine care only), a sham acupuncture intervention or another intervention in patients with migraine.
DATA COLLECTION AND ANALYSIS:
Two reviewers checked eligibility; extracted information on patients, interventions, methods and results; and assessed risk of bias and quality of the acupuncture intervention. Outcomes extracted included response (outcome of primary interest), migraine attacks, migraine days, headache days and analgesic use. Pooled effect size estimates were calculated using a random-effects model.
MAIN RESULTS:
Twenty-two trials with 4419 participants (mean 201, median 42, range 27 to 1715) met the inclusion criteria. Six trials (including two large trials with 401 and 1715 patients) compared acupuncture to no prophylactic treatment or routine care only. After 3 to 4 months patients receiving acupuncture had higher response rates and fewer headaches. The only study with long-term follow up saw no evidence that effects dissipated up to 9 months after cessation of treatment. Fourteen trials compared a 'true' acupuncture intervention with a variety of sham interventions. Pooled analyses did not show a statistically significant superiority for true acupuncture for any outcome in any of the time windows, but the results of single trials varied considerably. Four trials compared acupuncture to proven prophylactic drug treatment. Overall in these trials acupuncture was associated with slightly better outcomes and fewer adverse effects than prophylactic drug treatment. Two small low-quality trials comparing acupuncture with relaxation (alone or in combination with massage) could not be interpreted reliably.
AUTHORS' CONCLUSIONS:
In the previous version of this review, evidence in support of acupuncture for migraine prophylaxis was considered promising but insufficient. Now, with 12 additional trials, there is consistent evidence that acupuncture provides additional benefit to treatment of acute migraine attacks only or to routine care. There is no evidence for an effect of 'true' acupuncture over sham interventions, though this is difficult to interpret, as exact point location could be of limited importance. Available studies suggest that acupuncture is at least as effective as, or possibly more effective than, prophylactic drug treatment, and has fewer adverse effects. Acupuncture should be considered a treatment option for patients willing to undergo this treatment.