Table 1
Characteristics of included studies and the risk of bias associated with each study
| Study identification | Participants | Interventions | Timing of intervention | Primary outcome | Risk of bias summary | |||||||
| Age (years) | Course (years) | Acupuncture | Control | ① | ② | ③ | ④ | ⑤ | ⑥ | |||
| Ling Cao23 | A: 33.82±4.34 C: 33.86±4.85 | A: 0.25–11 C: 0.17–13 | Electroacupuncture; 14 sessions in 2 weeks | NSAIDs (Celebrex) | Premenstruation | Number of patients with improvement |  |  |  |  |  |  |
| Lina Chen et al20 | A: 29.81±4.32 C: 28.43±4.63 | A: 0.02–8 C: 0.01–9 | Manual acupuncture; 14 sessions in 2 weeks | NSAIDs (Celebrex) | Acute treatment | Time for headache relief |  |  |  |  |  |  |
| Xiaoting Fan et al18 | A: 26.65±4.58 C: 26.10±4.81 | A: 3.50±1.20 C: 3.20±0.90 | Moxibustion; 21 sessions in 3 weeks | NSAIDs (ibuprofen) | Premenstruation | Pain intensity measured by VAS |  |  |  |  |  |  |
| Li22 | A: 29.77±5.43 C: 31.31±5.65 | A: 1.13±0.44 C: 1.04±0.58 | Manual acupuncture; 18 sessions in 3 weeks | NSAIDs (ibuprofen) | Intramenstruation and premenstruation | Pain intensity measured by PRI |  |  |  |  |  |  |
| Linde et al16 | A: 35.20±7.5 S: 37.40±8.6 | Not reported | Electroacupuncture; 9 sessions in 3 weeks | Sham acupuncture (sham device) | Premenstruation | Monthly migraine attack frequency |  |  |  |  |  |  |
| Liu26 | A: 26.40±1.71 C: 25.30±2.01 | A: 6.04±0.51 C: 5.22±1.01 | Manual acupuncture; 28 sessions in 4 weeks | NSAIDs (aspirin) | Premenstruation | Pain intensity measured by VAS |  |  |  |  |  |  |
| Lv19 | A: 29.72±5.33 C: 28.57±5.43 | A: 6.17±1.81 C: 6.42±2.51 | Manual acupuncture; 21 sessions in 2 weeks | Flunarizine | Intramenstruation and premenstruation | Pain index score |  |  |  |  |  |  |
| Ma17 | A: 18–39 C: 19–40 | A: 1–4 C: 1–6 | Manual acupuncture; 9 sessions in 9 days | Flunarizine | Intramenstruation and premenstruation | Number of patients with improvement |  |  |  |  |  |  |
| Sun25 | 17–45 | 0.25–15 | Manual acupuncture; 15 sessions in 3 weeks | NSAIDs (ibuprofen) | Premenstruation | Number of patients with improvement |  |  |  |  |  |  |
| Liqiong Tian24 | A: 30.22±3.21 S: 31.65±3.12 | A: 2.14±1.22 S: 2.12±0.22 | Manual acupuncture; 20 sessions in 2 cycles | Sham acupuncture (non-acupoint) | Intramenstruation and premenstruation | Number of patients with improvement |  |  |  |  |  |  |
| Lihong Wang et al21 | A: 31.60±9.60 C: 32.60±8.90 | A: 0.98±0.33 C: 1.07±0.66 | Electroacupuncture; 24 sessions in 3 cycles | Flunarizine | Intramenstruation and premenstruation | Pain intensity measured by VAS |  |  |  |  |  |  |
| Yu and Salmoni15 | 22–52 | Not reported | Manual acupuncture; 9 sessions in 3 cycles | Sham acupuncture (irrelevant acupoint) | Premenstruation | Monthly migraine attack days |  |  |  |  |  |  |
| Zhou14 | A: 33.10±6.14 S: 33.27±6.87 | A: 7.40±6.31 S: 6.48±4.66 | Electroacupuncture; 27 sessions in 3 cycles | Sham acupuncture (non-acupoint) | Intramenstruation, premenstruation and postmenstruation | Monthly migraine attack frequency |  |  |  |  |  |  |
① random sequence generation (selection bias); ② allocation concealment (selection bias); ③ blinding of participants and personnel (performance bias); ④ blinding of outcome assessment (detection bias); ⑤ incomplete outcome data (attrition bias); ⑥ selective reporting (reporting bias).
low risk of bias;
unclear risk of bias;
high risk of bias.
A, acupuncture; C, control; NSAID, non-steroidal anti-inflammatory drug; PRI, Pain Rating Index; S, sham; VAS, Visual Analogue Scale.
