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Systematic review
Acupuncture for menstrual migraine: a systematic review
  1. Mingxiao Yang1,2,
  2. Ting Du3,
  3. Hulin Long4,
  4. Mingsheng Sun5,
  5. Fanrong Liang5 and
  6. Lixing Lao1,2
  1. 1 School of Chinese Medicine, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China
  2. 2 Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
  3. 3 Department of Rehabilitation, Xishan People’s Hospital, Wuxi, China
  4. 4 Department of Acupuncture and Rehabilitation, Chengdu University of Traditional Chinese Medicine Affiliated Hospital, Chengdu, Sichuan, China
  5. 5 School of Acupuncture & Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, China
  1. Correspondence to Dr Mingxiao Yang, School of Chinese Medicine, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China; mxyang{at}hku.hk; mingxiaoyang{at}hotmail.com

Abstract

Background and objective In clinical practice, the evidence of acupuncture used as a treatment for migraine without aura is employed interchangeably to guide treatment for menstrual migraine. However, its effect and safety are not substantiated. This study aimed to assess the efficacy of acupuncture on the frequency and pain intensity of menstrual migraine.

Methods We searched PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI) and other two Chinese databases from their inception to 1 May 2019. This study included randomised controlled trials of women with menstrual migraine receiving acupuncture or a valid control. Two reviewers independently completed study selection, data extraction and risk of bias assessment. We combined data with a fixed-effect model in RevMan. Clinical outcomes included migraine frequency and duration, headache intensity, and adverse events.

Results Thirteen studies with 826 subjects were included, 9 of which had data suitable for meta-analyses. Current evidence showed that acupuncture was not superior to sham acupuncture in reducing monthly migraine frequency and duration, average headache intensity, and analgesic use at completion of treatment or follow-up. Pooled data demonstrated a significant improvement in mean headache intensity in the acupuncture group compared with drugs. However, all studies were underpowered and associated with moderate to high risk of bias. No serious adverse event was related to acupuncture treatment.

Conclusions There is no convincing evidence to support the use of acupuncture in treating menstrual migraine. Acupuncture cannot yet be recommended to patients with menstrual migraine until more solid evidence is produced.

Trial registration number CRD42019119337.

  • chronic conditions
  • complementary therapy
  • pain
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjspcare-2019-002024

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    Footnotes

    • Correction notice This article has been updated since it was first published. The article type has been changed to Systematic review.

    • Contributors MY and LL contributed to the conception and design of the study. FL, TD and MS revised the study protocol. MY, TD, HL and MS contributed to the acquisition and analysis of data. TD and MS evaluated the risk of bias of the included studies. MY, FL and LL interpreted the data. MY and TD drafted the manuscript. LL, MS, HL and FL critically revised the manuscript.

    • Funding This project was funded by the National Natural Science Foundation of China (grant number 81904304) and the Young Elite Scientists Sponsorship Program by the CAST (YESS).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.