PDF: Acupuncture for Episodic Migraine
(2020)Objective
Acupuncture - To determine whether manual acupuncture reduces migraine frequency and severity in acupuncture-naive patients with episodic migraine without aura compared to sham acupuncture or usual care.
Study Summary
• 82.5% achieved ≥50% reduction in migraine days
• Improvements in pain, disability, and quality of life were statistically significant
Intervention
150 patients randomized to 8 weeks of manual acupuncture, sham acupuncture, or usual care, with 12-week follow-up. All patients were acupuncture-naive and had 2–8 migraine attacks at baseline.
Inclusion Criteria
• Age 15–65
• Episodic migraine without aura
• Migraine history >12 months
• 2–8 attacks in baseline month
• No prior acupuncture
Study Design
Arms: Manual acupuncture vs sham acupuncture vs usual care
Patients per Arm: 50 per group (3 groups total)
Outcome
• 82.5% in acupuncture group had ≥50% reduction in migraine days
• VAS and MIDAS scores improved significantly
Bottom Line
Manual acupuncture significantly reduced migraine days and attacks compared to sham acupuncture and usual care, supporting its use as an effective non-drug prophylactic treatment for episodic migraine without aura.
Major Points
- 150 acupuncture-naive patients with episodic migraine were randomized to manual acupuncture, sham acupuncture, or usual care
- 20 sessions were administered over 8 weeks with 12-week follow-up (total 20 weeks)
- Manual acupuncture significantly reduced migraine days and attacks vs sham and usual care
- Blinding was successful, with no difference in perceived penetration between manual and sham groups
- Manual acupuncture improved quality of life scores and disability scores more than controls
- No serious adverse events were reported
Study Design
- Study Type
- Multicentre, randomized, controlled clinical trial
- Randomization
- Yes
- Blinding
- Participants, outcome assessors, and statisticians were blinded
- Sample Size
- 150
- Follow-up
- 20 weeks (8 weeks treatment, 12 weeks follow-up)
- Centers
- 7
- Countries
- China
Primary Outcome
Definition: Change in number of migraine days and migraine attacks per 4-week period from baseline to weeks 17–20
| Control | Intervention | HR/OR | P-value |
|---|---|---|---|
| Migraine days: -1.4; attacks: -0.4 | Migraine days: -3.9; attacks: -2.3 | - (Days: -2.4 to -1.4; Attacks: -1.5 to -0.5) | <0.001 |
Limitations & Criticisms
- Short follow-up (only 12 weeks after treatment)
- No active drug comparator (e.g., pharmacologic prophylaxis)
- Results may not generalize to patients with prior acupuncture experience
Citation
BMJ 2020;368:m697