Acupuncture for migraine: A systematic review and meta-regression of randomized controlled trials

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Chunyan Yang , Min Wu , Qin Luo , Guixing Xu , Liuyang Huang , Hao Tian , Mingsheng Sun , Fanrong Liang
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引用次数: 0

Abstract

Objectives

This meta-analysis aimed to explore the relationship between the dose of acupuncture sessions, acupuncture frequency, and acupuncture duration and its effects on migraine.

Methods

Eight databases were searched for randomized controlled trials (RCTs) evaluating the efficacy of penetrating manual acupuncture for migraine published in English and Chinese from inception to June 20, 2024. The robust-error meta-regression (REMR) approach and non-linear meta-regression with restricted cubic spline (RCS) were used to investigate the dose-response association between acupuncture sessions, acupuncture frequency, and acupuncture duration and the frequency of migraine attacks. The potential nonlinear relationships was tested by restricting the regression coefficient to zero and a P value<0.1. The statistical analysis was conducted using Stata 17.0. The risk of bias was independently assessed by two reviewers using the Cochrane tool. The reporting quality for acupuncture procedures was evaluated by STRICTA criteria.

Results

Thirty-two RCTs involving 1562 participants were included, and the results showed a J-shaped dose-response association between acupuncture sessions, acupuncture frequency, and acupuncture duration and migraine attack frequency. After 16 acupuncture sessions, the change in the frequency of migraine attacks was 3.95 (95 %CI: 3.13 to 4.77). Three sessions of acupuncture a week resulted in a significant decrease in the frequency of migraine attacks, reaching 4.04 (95 % CI: 2.49 to 5.58). After two months of acupuncture, the frequency of migraine attacks decreased significantly, showing a difference of 4.05 (95 % CI: 3.61 to 4.49). Subsequently, the improvement trend gradually flattened, yielding diminishing benefits to patients. The risk of bias showed that seven studies were rated as “low risk”, two were rated as “high risk”, and the others were rated as “unclear risk”. The reporting quality of RCTs of acupuncture for migraine remain suboptimal.

Conclusions

A non-linear dose-response relationship was found between acupuncture sessions, acupuncture frequency, and acupuncture duration and migraine attack frequency. The results of our study recommend 16 sessions of acupuncture with a frequency of 3 sessions/week and a treatment duration of 1.5 to 2 months.

Registration number

This meta-analysis has been registered on PROSPERO (CRD42023400493).

针灸治疗偏头痛:随机对照试验的系统回顾和元回归。
目的本荟萃分析旨在探讨针灸疗程剂量、针灸频率和针灸持续时间与偏头痛疗效之间的关系:方法:在8个数据库中检索了从开始到2024年6月20日期间用中英文发表的评估针刺治疗偏头痛疗效的随机对照试验(RCT)。采用稳健-误差元回归(REMR)方法和限制性立方样条非线性元回归(RCS)研究针灸疗程、针灸频率和针灸持续时间与偏头痛发作频率之间的剂量-反应关系。通过限制回归系数为零和P值<0.1来检验潜在的非线性关系。统计分析使用Stata 17.0进行。偏倚风险由两名审稿人使用 Cochrane 工具进行独立评估。针灸程序的报告质量按照 STRICTA 标准进行评估:结果显示,针灸疗程、针灸频率和针灸持续时间与偏头痛发作频率之间呈 "J "形剂量-反应关系。针灸16次后,偏头痛发作频率的变化为3.95(95%CI:3.13至4.77)。每周针灸三次可显著降低偏头痛发作频率,达到 4.04(95% CI:2.49 至 5.58)。针灸两个月后,偏头痛发作频率明显下降,差异为 4.05(95% CI:3.61 至 4.49)。随后,改善趋势逐渐趋于平缓,患者获益逐渐减少。偏倚风险显示,7 项研究被评为 "低风险",2 项研究被评为 "高风险",其他研究被评为 "风险不明确"。针灸治疗偏头痛的研究性临床试验的报告质量仍然不够理想:结论:针灸疗程、针灸频率和针灸持续时间与偏头痛发作频率之间存在非线性剂量-反应关系。我们的研究结果建议针灸疗程为 16 次,频率为 3 次/周,疗程为 1.5 至 2 个月:本荟萃分析已在 PROSPERO 上注册(CRD42023400493)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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