Acupuncture for migraine: a systematic review and meta-analysis

Objective: The goal of this study is to systematically assess the effectiveness of acupuncture compared with medication for migraine.Methods: The Cochrane Library, PubMed, MEDLINE, Embase, China National Knowledge Infrastructure (CNKI), Sinomed, the Chongqing VIP full-text periodical database (VIP) and Wanfang were searched by computer to identify the randomized controlled trails comparing acupuncture with medication for migraine from the beginning of these databases to August 2018, supplementing with literature retrospective and manual searches. Review Manager 5.2 was used for statistical analysis.Results: A total of 13 trails including 1218 participants met the selection criteria. (1) The meta-analysis of 3 articles showed that acupuncture was more effective in reducing the frequency of migraine attacks (MD = -2.03; 95% CI: -2.77 to -1.30; P < 0.00001) than medication. (2) The meta-analysis of three articles showed that acupuncture was more effective in reducing the number of migraine days (MD = -1.65; 95% CI: -2.78 to -0.52; P = 0.004) than medication after treatment. (3) The meta-analysis of six articles showed that acupuncture was more effective in reducing VAS (MD = -1.26; 95% CI: -1.48 to -1.04; P < 0.00001) after treatment. (4) The meta-analysis of two articles showed that acupuncture was more effective in reducing VAS (MD = -1.07; 95% CI: -1.63 to -0.51; P = 0.0002) during follow-up. (5) The meta-analysis of seven articles showed that the total effective rate of acupuncture was higher than that of medication (MD = 1.27; 95% CI: 1.16 to 1.37; P < 0.00001). In addition, fewer adverse effects in acupuncture groups were reported than in medication groups. Overall the quality of the evidence was low.Conclusion: The results of this meta-analysis showed that acupuncture is more effective and safer than medication for migraine. Acupuncture can be considered a treatment option for patients willing to undergo this treatment. But more high-quality studies, based on standardized, comprehensive and objective evaluation, are required to enhance the reliability of the conclusion. (C) 2019 World Journal of Acupuncture Moxibustion House. Published by Elsevier B.V. All rights reserved.