Acupuncture for Treating Acute Attacks of Migraine: A Randomized Controlled Trial
Acupuncture for Treating Acute Attacks of Migraine: A Randomized Controlled Trial
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DOI：
10.1111/j.1526-4610.2009.01424.x
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发表时间：
2009-06-01
期刊：
影响因子：
5
通讯作者：
Zou Ran
中科院分区：
文献类型：
--
作者：
Li Ying;Liang Fanrong;Zou Ran
目的：探讨针刺治疗偏头痛急性发作的多中心随机对照试验结果。针刺治疗偏头痛在中国已有数百年的历史。然而，迄今为止，关于其缓解疼痛的有效性的令人信服的证据还不充分。共有218名偏头痛患者被招募参加这项研究; 180名符合纳入标准; 175名完成了召回过程，并被随机分为3组。一组接受真针治疗，另两组接受假针治疗。每例患者接受1次治疗，并观察24小时。主要观察指标为治疗前和治疗后0.5、1、2、4小时的视觉模拟量表（VAS）评分，治疗后第4小时观察到接受真针或假针刺的患者VAS评分较基线显著降低（P <0.05）。治疗后第4小时，真针组、假针1组和假针2组的VAS评分分别下降了1.0 cm、0.5 cm和0.1 cm。同样，3组治疗后第2小时VAS评分较基线的变化存在显著差异（P = .006）。此外，在治疗后第二小时，只有接受真针治疗的患者显示VAS评分较基线显著降低，中位数为0.7 cm（P <0.001）。治疗后24小时内疼痛缓解、复发或加重以及一般评价在3组之间观察到显著差异（P <0.05）。针刺组大部分患者疼痛完全缓解（40.7%），无疼痛复发或加重（79.6%），针刺治疗在减轻急性偏头痛不适方面优于假针刺（以中西非穴位为基础）。Verum针灸在缓解疼痛和预防偏头痛复发或加重方面也明显有效。这些发现支持了这样一种观点，即有特定的生理效应可以区分真正的穴位和非穴位。
To discuss the results of a multicenter randomized controlled trial of the efficacy of verum acupuncture in treating acute migraine attacks.Acupuncture has been used in China for centuries to treat migraine headache. Convincing evidence of its efficacy in alleviating pain, however, has been inadequate to date.A total of 218 patients with migraine were recruited for the study; 180 met the inclusion criteria; 175 completed the callback process and were randomized into 3 groups. One group received verum acupuncture while subjects in the other 2 groups were treated with sham acupuncture. Each patient received 1 session of treatment and was observed over a period of 24 hours. The main outcome measure was the differences in visual analog scale (VAS) scores before treatment and 0.5, 1, 2, and 4 hours after treatment.Significant decreases in VAS scores from baseline were observed in the fourth hour after treatment when VAS was measured in the patients who received either verum acupuncture or sham acupunctures (P < .05). The VAS scores in the fourth hour after treatment decreased by a median of 1.0 cm, 0.5 cm, and 0.1 cm in the verum acupuncture group, sham acupuncture group 1, and sham acupuncture group 2, respectively. Similarly, there was a significant difference in the change in VAS scores from baseline in the second hour after treatment among the 3 groups (P = .006). Moreover, at the second hour after treatment, only patients treated with verum acupuncture showed significant decreases in VAS scores from baseline by a median of 0.7 cm (P < .001). Significant differences were observed in pain relief, relapse, or aggravation within 24 hours after treatment as well as in the general evaluations among the 3 groups (P < .05). Most patients in the acupuncture group experienced complete pain relief (40.7%) and did not experience recurrence or intensification of pain (79.6%).Verum acupuncture treatment is more effective than sham acupuncture based on either Chinese or Western nonacupoints in reducing the discomfort of acute migraine. Verum acupuncture is also clearly effective in relieving pain and preventing migraine relapse or aggravation. These findings support the contention that there are specific physiological effects that distinguish genuine acupoints from nonacupoints.