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Acupuncture for Patients With Migraine
A Randomized Controlled Trial
Klaus Linde, MD;
Andrea Streng, PhD;
Susanne Jürgens, MSc;
Andrea Hoppe, MD;
Benno Brinkhaus, MD;
Claudia Witt, MD;
Stephan Wagenpfeil, PhD;
Volker Pfaffenrath, MD;
Michael G. Hammes, MD;
Wolfgang Weidenhammer, PhD;
Stefan N. Willich, MD, MPH;
Dieter Melchart, MD
JAMA. 2005;293:2118-2125.
Context Acupuncture is widely used to prevent migraine attacks, but the available evidence of its benefit is scarce.
Objective To investigate the effectiveness of acupuncture compared with sham acupuncture and with no acupuncture in patients with migraine.
Design, Setting, and Patients Three-group, randomized, controlled trial (April 2002-January 2003) involving 302 patients (88% women), mean (SD) age of 43 (11) years, with migraine headaches, based on International Headache Society criteria. Patients were treated at 18 outpatient centers in Germany.
Interventions Acupuncture, sham acupuncture, or waiting list control. Acupuncture and sham acupuncture were administered by specialized physicians and consisted of 12 sessions per patient over 8 weeks. Patients completed headache diaries from 4 weeks before to 12 weeks after randomization and from week 21 to 24 after randomization.
Main Outcome Measures Difference in headache days of moderate or severe intensity between the 4 weeks before and weeks 9 to 12 after randomization.
Results Between baseline and weeks 9 to 12, the mean (SD) number of days with headache of moderate or severe intensity decreased by 2.2 (2.7) days from a baseline of 5.2 (2.5) days in the acupuncture group compared with a decrease to 2.2 (2.7) days from a baseline of 5.0 (2.4) days in the sham acupuncture group, and by 0.8 (2.0) days from a baseline if 5.4 (3.0) days in the waiting list group. No difference was detected between the acupuncture and the sham acupuncture groups (0.0 days, 95% confidence interval, –0.7 to 0.7 days; P = .96) while there was a difference between the acupuncture group compared with the waiting list group (1.4 days; 95% confidence interval; 0.8-2.1 days; P<.001). The proportion of responders (reduction in headache days by at least 50%) was 51% in the acupuncture group, 53% in the sham acupuncture group, and 15% in the waiting list group.
Conclusion Acupuncture was no more effective than sham acupuncture in reducing migraine headaches although both interventions were more effective than a waiting list control.
Author Affiliations: Centre for Complementary Medicine Research, Department of Internal Medicine II (Drs Linde, Streng, Hoppe, Weidenhammer, and Melchart and Mrs Jürgens), Institute of Medical Statistics and Epidemiology (Dr Wagenpfeil), and Department of Neurology (Dr Hammes), Technische Universität München, Munich, Germany; Institute of Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany (Drs Brinkhaus, Witt, and Willich); Munich, Germany (Dr Pfaffenrath); and Division of Complementary Medicine, Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland (Dr Melchart).
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