Traditional Acupuncture in Migraine: A Controlled, Randomized Study

Authors: Facco, Enrico; Liguori, Aldo; Petti, Filomena; Zanette, Gastone; Coluzzi, Flaminia; De Nardin, Marco; Mattia, Consalvo

Source: Headache: The Journal of Head and Face Pain, Volume 48, Number 3, March 2008 , pp. 398-407(10)

Publisher: Wiley-Blackwell

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Abstract:

(Headache 2008;48:398-407) Objective.—

To check the effectiveness of a true acupuncture treatment according to traditional Chinese medicine (TCM) in migraine without aura, comparing it to a standard mock acupuncture protocol, an accurate mock acupuncture healing ritual, and untreated controls. Background.—

Migraine prevalence is high and affects a relevant rate of adults in the productive phase of their life. Acupuncture has been increasingly advocated and used in Western countries for migraine treatment, but the evidence of its effectiveness still remains weak. A large variability of treatments is present in published studies and no acupoint selection according to TCM has been investigated so far; therefore, the low level of evidence of acupuncture effectiveness might partly depend on inappropriate treatment. Design and Methods.—

A prospective, randomized, controlled study was performed in 160 patients suffering from migraine without aura, assessed according to the ICD-10 classification. The patients were divided into the following 4 groups: (1) group TA, treated with true acupuncture (according to TCM) plus Rizatriptan; (2) group RMA, treated with ritualized mock acupuncture plus Rizatriptan; (3) group SMA, treated with standard mock acupuncture plus Rizatriptan; (4) group R, without prophylactic treatment with relief therapy only (Rizatriptan). The MIDAS Questionnaire was administered before treatment (T0), at 3 (T1) and 6 months (T2) from the beginning of treatment, and the MIDAS Index (MI) was calculated. Rizatriptan intake was also checked in all groups of patients at T0, T1, and T2. Group TA and RMA were evaluated according to TCM as well; then, the former was submitted to true acupuncture and the latter to mock acupuncture treatment resembling the same as TA. The statistical analysis was conducted with factorial ANOVA and multiple tests with a Bonferroni adjustment. Results.—

A total of 127 patients completed the study (33 dropouts): 32 belonged to group TA, 30 to group RMA, 31 to group SMA, and 34 to group R. Before treatment the MI (T₀) was moderate to severe with no significant intergroup differences. All groups underwent a decrease of MI at T₁ and T₂, with a significant group difference at both T₁ and T₂ compared to T₀ (P < .0001). Only TA provided a significant improvement at both T₁ and T₂ compared to R (P < .0001). RMA underwent a transient improvement of MI at T₁. The Rizatriptan intake paralleled the MI in all groups. Conclusions.—

TA was the only treatment able to provide a steady outcome improvement in comparison to the use of only Rizatriptan, while RMA showed a transient placebo effect at T1.

Keywords: migraine; acupuncture; mock acupuncture; rizatriptan; MIDAS questionnaire; outcome

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1526-4610.2007.00916.x

Publication date: 2008-03-01

Traditional Acupuncture in Migraine: A Controlled, Randomized Study

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