EBP107: Systematic Review of Acupuncture vs. Migraine Treatment

This report presents a comprehensive analysis of a systematic review comparing acupuncture with standard pharmacological therapy for migraine prevention. The study investigated the efficacy of acupuncture as a preventative treatment for migraines, exploring its advantages and disadvantages compared to traditional drug-based interventions. The research included a detailed examination of study design, participant demographics, overall outcomes, and ethical considerations. The findings suggest that acupuncture may be more effective than standard drug therapy in some cases, with fewer side effects. The report also discusses the implications of these findings for clinical practice, highlighting the need for standardized protocols in acupuncture research. It also includes details on the hierarchy of evidence and references used in the study.

EBP107 Evidence-Based Practice

Table of contents
Reason for undertaking the study...............................................................................................1
Aim or hypothesis of the study....................................................................................................1
Participants of the study..............................................................................................................1
Study design..................................................................................................................................1
Overall outcome of the study.......................................................................................................1
Discussion of implications for clinical practice in the study.....................................................1
Ethical considerations..................................................................................................................1
Hierarchy of evidence...................................................................................................................1
References.......................................................................................................................................1

Article summary
Reason for undertaking the study:
Systematic Review of Acupuncture vs. Standard Pharmacological Therapy for Migraine
Prevention has been investigated in this work.
Aim and hypothesis of the study:
Numerous deficiencies exist in the conventional pharmacological management of headache.
Although its importance in comparison to pharmaceutical medications is still noted, even though
many of them are effective, acupuncture has emerged as a more comprehensive therapeutic
method for the prevention and treatment of headaches. Class A and B do not have any supporting
evidence. This is a methodical compilation of data from randomized pilot studies that have
already been conducted to assess the viability of acupuncture treatment versus traditional
painkillers for headache suppression. The developers found that acupuncture was at least more
attractive than prophylactic drug treatment, perhaps more viable, and had less antagonistic
effects. Starting around 2016, a few new investigations seem to help the adequacy of needle
therapy in headache avoidance. This article is an engaged, orderly survey of high quality,
randomized controlled preliminaries that study the successfulness of needle therapy for the
treatment of rambling, or ongoing headache contrasted with the adequacy of standard
pharmacological treatments for the treatment of headache. Moreover, we inspected and summed
up point determination, treatment period, complete number of treatment meetings, and the
recurrence of medicines (Zhang et al., 2020).
Participants of the study:
All abstracts distinguished by the inquiry technique were reviewed by a single analyst. There
were 706 articles in all that the custom search algorithm produced. There were exactly 158
specimens removed. In light of the hypothetical title, 318 more intangibles were eliminated. The
whole text of 230 articles was read. Seven articles were chosen by an analyst for consideration.
Obviously, superfluous articles and duplication are avoided. The full text of critical articles was
reviewed by two commenters. Review of the brain pain regimens used, number of patients
randomly assigned, disclosure of the SRICTA Acupuncture Protocol (Principles for Reporting

Interventions in Preclinical Acupuncture Trials)5, length of treatment and follow-up, number of
non-matchers, and quality of treatment were some of the information extracted (absolute number
of sessions, repetitions, duration of each session, score). Each analyst compiled the removed data
into an account structure, which was then examined. Conversations were used to resolve
disputes.
Study Design:
Scopus, PubMed, and MEDLINE are all searched using unique methods (including EMBASE).
English and a randomly chosen qualifier were the exam requirements. No timeframe limitations
were applied. Review of the brain pain groups employed, the number of patients randomised,
disclosure of the SRICTA Acupuncture Rules, five treatment and follow-up periods, the number
of non-conformers, and treatment features were some of the information extracted (absolute
number of meetings, repetition, duration of each meeting, points vote). Individual information
was combined into account structures, where it was considered by each analyst. Conversations
were used to settle disputes.
Overall outcome of the study:
Of the 706 indexed list, seven preclinical trials with a total of 1430 members encountered a
pretrial inclusion model comparing adequacy of acupuncture with standard pharmacological
care. Some studies have shown that acupuncture is more viable than standard drug therapy for
headache prevention. Regardless, strategic heterogeneity prevented collation of this information.
We evaluated a sum of 7 randomized controlled preliminaries, 2 of which concentrated on
patients with persistent headache, while the other 5 examinations enlisted patients with
roundabout headache. The frequency of unkind events was definitely higher in the group using
standard pharmacological intercession. During his initial four months of treatment, needle
therapy was more powerful at lessening the quantity of assaults; in any case, following a half
year, there was no distinction. Contrasted with the members who got needle therapy in addition
to flunarizine, a greater amount of the subjects in the hoax needle therapy bunch saw essentially
a half decrease in headache days (Kings, P 0.05). Yan and co. The quantity of month-to-month
headache days was seen to be diminished more by the needle therapy pack than by the
topiramate group. Diener et al. did exclude a mean decrease in headache days among center
gatherings, which contained acucut, beta blockers, valproic corrosive, and flunarizine. Because

of the huge dropout rate in the metoprolol bundle, Streng et al. were basically ready to lead
exploratory butt-centricities.
Treatment tolerability and safety are important factors in increasing consistency. Several major
studies have shown that acupuncture is tolerable and that serious entanglements rarely occur.
Patients had to drop out in the face of antagonism. Detailed outcomes of acupuncture included
mild drainage at the needle insertion site, ecchymosis, local pain, sedation, and weakness. It was
According to reliable general studies, acupuncture's negative effects start to manifest more
gradually than those of beta-blockers, valproic acid, topiramate, and flunarizine.
Discussion of implications for clinical practice in the study:
Many people who experience headaches are unwilling or unable to use conventional prophylactic
drugs. A growing body of research shows that acupuncture can treat chronic headaches safely
and effectively. In any case, there are as yet numerous impediments related with the
heterogeneity in concentrate on convention of acupuncture research studies. Later on, it is
fundamental to foster a normalized convention for point choice, treatment recurrence and span,
and an all-inclusive farce needle therapy convention. According to a study by American
Migraine Pervasiveness and Prevention (AMPP), most individuals with severe headaches were
resistant to minor pharmacological adjustments (Li et al., 2013). There is mounting evidence that
acupuncture is more effective overall and causes fewer side effects than many of the
conventional mumbling pharmacists. In clinical practice, patients much of the time request
direction on the choice about whether to attempt needle therapy what's more, about how
successive and how lengthy they need to attempt it for. In any case, we actually have very little
comprehending of the instrument by which needle therapy works also, the information is as yet
restricted. Since the publication of a targeted study by Linde et al. in 2016, a number of new
studies have demonstrated that acupuncture is more effective than conventional pharmaceutical
treatments for reducing headaches. An extensive assessment of previous randomized controlled
trials was undertaken centrally to concentrate on the suitability of acupuncture. We also analyzed
the duration and repetition of treatment. Our goal was to use accessible information to design a
beneficial outcome summary for clinicians and their patients (Linde et al., 2016).
Ethical considerations:

In light of moderate conviction of evidence, we reason that needle therapy is somewhat more
compelling and a lot more secure than prescription for the prophylaxis of headache. SM and MC
conceptualized and planned the review, screened examinations from title and dynamic, removed
information from included investigations, surveys hazard of inclination, attempted information
investigation, assessed the conviction of proof, and drafted the underlying composition. CG, SC,
and AM composed the presentation and the conversation. All survey writers added to composing
and reexamining the last composition. The most recent changes to STRICTA (Standards for
Reporting Interventions in Clinical Trials of Acupuncture) are typically intended to improve on
the preliminary information about acupuncture and to manipulate its translation and replication.
Only the papers by Yang et al. and Facco et al. specifically discuss SRICTA compliance among
those we analysed.
Hierarchy of evidence:
We evaluated the general nature of the evidence for the essential results utilizing the five
GRADE spaces (concentrate on restrictions, consistency of impact, imprecision, aberrance, and
distribution inclination) as indicated by the GRADE approach (32). In view of the above spaces,
the GRADE framework utilizes the accompanying standards to grade the proof:
High: we are extremely certain that the genuine impact lies near that of the gauge of the impact.
Moderate: we are reasonably certain about the impact gauge: the genuine impact is probably
going to be near the gauge of the impact, however there is plausible that it is significantly
unique.
Low: our trust in the impact gauge is restricted: the genuine impact might be considerably not
quite the same as the gauge of the impact.
Extremely low: we don't especially trust the impact gauge: the genuine impact is probably going
to be considerably not quite the same as the gauge of impact.
The current proof was summed up in a "Rundown of Findings" table that gives key data about
the extents of relative and outright impacts of the mediations, how much accessible proof and the
sureness of accessible evidence.

References
Li, Q. Q., Shi, G. X., Xu, Q., Wang, J., Liu, C. Z., & Wang, L. P. (2013). Acupuncture effect and
central autonomic regulation. Evidence-Based Complementary and Alternative Medicine,
2013.
Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Vertosick, E. A., ... & White, A. R.
(2016). Acupuncture for the prevention of episodic migraine. Cochrane Database of
Systematic Reviews, (6).
Zhang, N., Houle, T., Hindiyeh, N., & Aurora, S. K. (2020). Systematic review: acupuncture vs
standard pharmacological therapy for migraine prevention. Headache: The Journal of
Head and Face Pain, 60(2), 309-317.