[Optimized schemes for acupuncture treatment of migraine during attack].

ABSTRACT

OBJECTIVE: To observe the therapeutic effect of manual acupuncture, electroacupuncture (EA), auricular acupuncture and bloodletting therapies combined with orthogonal design for migraine patients, so as to select a better scheme for relieving headache. METHODS: total of 76 migraine patients in the stage of attack were recruited in the present study and randomly (stratified random and central random) allocated to 9 groups by means of orthogonal experimental design [L9 (3(4)), 4 factors (F) and three levels (L)] i.e., F1 ody-acupoints combination; F1-L1 regional acupoints [Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5), etc.] near the focus, F1-L2regional +distal acupoints [Hegu (L 4), Taichong (LR 3), etc.] far from the focus, and F1-L3regional + remote acupoints+ those selected according to syndrome differentiation [for instance, Ganshu (BL 18), Yanglingquan (GB 34), Qiuxu (GB 40) and Taixi (KI 3) for hyperactivity of Liver-yang, etc.]; F2 manual acupuncture or EA of body acupoints; F2-L1no acupuncture stimulation, F2-L2manual acupuncture stimulation, and F2-L3manual + EA stimulation; F3 auricular acupuncture therapy; F3-L1no acupuncture stimulation, F3-L2 otopoint-manual acupuncture (Shenmen, Jiaogan, etc.), and F3-L3otopoint-EA; F4 bloodletting; F4-L1 EX-HN 5 + Ashi point bloodletting, F4-L2EX-HN5 bloodletting, and F4-L3 no bloodletting. The therapeutic effect of acupuncture was evaluated using Visual Analogue Scale (VAS) and analyzed by investigators who did not participate in the treatment course. RESULTS: Within 24 hours after the treatment, the four factors influencing headache relief from bigger to smaller are body-acupoints combination > manual acupuncture or EA stimulation > bloodletting > auricular acupuncture. Among the therapeutic schemes evaluated by orthogonal deduction, the analgesic effect was most stable in the manual acupuncture at regional + distal acupoints group which was recommended to be the ba-sic scheme for migraine. The auricular EA could effectively reduce VAS levels from 10 min to 30 min after stimulation, while bloodletting at Taiyang (EX-HN 5)+ Ashi points was effective in relieving migraine from 4 h to 24 h after the treatment, suggesting a long lasting post-therapeutic analgesic effect. CONCLUSION: Manual acupuncture stimulation of the local + distal body acupoints combined with otopoint-EA and bloodletting at Taiyang (EX-HN 5) + Ashi points is the best option for relieving migraine during attack.