Acupuncture in patients with tension-type headache: randomised controlled trial

Melchart, Dieter; Streng, Andrea; Hoppe, Andrea; Brinkhaus, Benno; Witt, Claudia M.; Wagenpfeil, Stefan; Pfaffenrath, V.; Hammes, Michael; Hummelsberger, J.; Irnich, Dominik; Weidenhammer, Wolfgang; Willich, Stefan N.; Linde, Klaus

doi:10.1136/bmj.38512.405440.8f

Cited by 365 publications

(251 citation statements)

References 19 publications

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“…The lack of a difference between true and sham acupuncture in that study is in line with previous studies on different pain conditions and nausea caused by chemotherapy that demonstrated that true acupuncture is not more effective than sham acupuncture. However, all of these trials found a significant effect when groups were compared with a nonintervention group (8,22,28). These results indicate that sham acupuncture is not an inert method and highlight the methodological difficulties in the design of acupuncture trials.…”

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confidence: 77%

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Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial

Johansson

Redman

Veldhuis

et al. 2013

American Journal of Physiology-Endocrinology and Metabolism

114

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Acupuncture has been demonstrated to improve menstrual frequency and to decrease circulating testosterone in women with polycystic ovary syndrome (PCOS). Our aim was to investigate whether acupuncture affects ovulation frequency and to understand the underlying mechanisms of any such effect by analyzing LH and sex steroid secretion in women with PCOS. This prospective, randomized, controlled clinical trial was conducted between June 2009 and September 2010. Thirty-two women with PCOS were randomized to receive either acupuncture with manual and low-frequency electrical stimulation or to meetings with a physical therapist twice a week for 10 -13 wk. Main outcome measures were changes in LH secretion patterns from baseline to after 10 -13 wk of treatment and ovulation frequency during the treatment period. Secondary outcomes were changes in the secretion of sex steroids, anti-Müllerian hormone, inhibin B, and serum cortisol. Ovulation frequency during treatment was higher in the acupuncture group than in the control group. After 10 -13 wk of intervention, circulating levels of estrone, estrone sulfate, estradiol, dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, testosterone, free testosterone, dihydrotestosterone, androsterone glucuronide, androstane-3␣,17␤-diol-3-glucuronide, and androstane-3␣,17␤-diol-17-glucuronide decreased within the acupuncture group and were significantly lower than in the control group for all of these except androstenedione. We conclude that repeated acupuncture treatments resulted in higher ovulation frequency in lean/overweight women with PCOS and were more effective than just meeting with the therapist. Ovarian and adrenal sex steroid serum levels were reduced with no effect on LH secretion. polycystic ovary syndrome; acupuncture; ovulation; lh pulsatility; sex steroids THE MAIN CHARACTERISTICS of polycystic ovary syndrome (PCOS) are polycystic ovaries (34), oligo/anovulation, and elevated serum levels of sex steroid precursors, estrogens, androgens, and glucuronidated androgen metabolites (38). PCOS is related to hyperinsulinemia and insulin resistance and is exacerbated by obesity (7). Numerous studies have reported hypersecretion of luteinizing hormone (LH) in women with PCOS (3). Together with an exaggerated ovarian response, hypersecretion of LH drives excessive ovarian androgen production and causes anovulation (13). In PCOS, altered sex steroid production, metabolic dysfunction, and obesity all contribute to changes in LH secretion patterns and to anovulation (6,12,29,30).Clomiphene citrate, exogenous gonadotropin therapy, and laparoscopic ovarian drilling are commonly used to induce ovulation in women with PCOS (1). These treatments often have negative side effects, thus indicating the importance of evaluating alternative treatments such as acupuncture. Acupuncture is used worldwide to achieve fertility, but its efficacy is supported by only limited scientific evidence. In a randomized controlled trial (RCT), we previously demonstrated that acupuncture w...

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confidence: 77%

“…In the present study, we did not use placebo or sham needles or minimal acupuncture, because studies suggest that that these are not inert treatments (8,22,23,28). Instead, our research question aimed to elucidate whether acupuncture is superior to the time and attention of meeting with the therapist.…”

Section: E940mentioning

confidence: 99%

Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial

Johansson

Redman

Veldhuis

et al. 2013

American Journal of Physiology-Endocrinology and Metabolism

114

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“…The largest of these, which compared 132 verum patients with 63 sham controls [29], reported smaller overall decreases in headache days per month with no statistically significant differences between groups (41% verum vs. 37% sham, p=0.58 compared to 62% verum vs. 50% sham, p<0.001). The results of the other large randomised trial for chronic headache cannot be directly compared with ours as headache days was not an endpoint; nonetheless, a statistically significant difference was reported between patients randomised to acupuncture plus specialist headache care compared to those receiving specialist headache care alone [23].…”

Section: Discussionmentioning

confidence: 99%

Acupuncture for Tension-Type Headache: a Multicentre, Sham-Controlled, Patient and Observer-Blinded, Randomised Trial

Endres

Böwing²,

Diener

et al. 2008

Deutsche Zeitschrift für Akupunktur

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Acupuncture treatment is frequently sought for tension-type headache (TTH), but there is conflicting evidence as to its effectiveness. This randomised, controlled, multicentre, patient-and observerblinded trial was carried out in 122 outpatient practices in Germany on 409 patients with TTH, defined as ≥10 headache days per month of which ≤1 included migraine symptoms. Interventions were verum acupuncture according to the practice of traditional Chinese medicine or sham acupuncture consisting of superficial needling at nonacupuncture points. Acupuncture was administered by physicians with specialist acupuncture training. Ten 30-min sessions were given over a six-week period, with additional sessions available for partial response. Response was defined as >50% reduction in headache days/month at six months and no use of excluded concomitant medication or other therapies. In the intent-to-treat analysis (all 409 patients), 33% of verum patients and 27% of sham controls (p ( =0.18) were classed as responders. Verum was superior to sham for most secondary endpoints, including headache days (1.8 fewer; 95% CI 0.6, 3.0; p=0.004) and the International Headache Society response criterion (66% vs. 55% response, risk difference 12%, 95% CI: 2%-

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“…Two unblinded (potential bias) trials reported benefit of acupuncture in treating acute headaches in comparison to normal standard of care or acute pharmaceutical intervention [57,67]. A systemic review and meta-analysis of 8 randomised controlled trials comparing acupuncture and sham procedure in TTH prophylaxis showed no significant benefit in the acupuncture arm in reducing headache frequency [68,69].…”

Section: Acupuncture Vs Acute Treatmentsmentioning

confidence: 99%

“…Melchart in 2005 [57] in their study on 270 patients evaluated the effectiveness of traditional acupuncture with superficial acupuncture or no treatment in patients with TTH. Patients were randomised to receive 12 sessions of either treatment.…”

Section: Earlier Trialsmentioning

confidence: 99%

Acupuncture in Primary Headache Disorders; Review of the Evidence

Zaidi¹,

Ahme²

2016

J Neurol Disord

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Primary headache disorders affect large number of people worldwide. Migraine and tension type headaches constitute 95% of all headaches. Both tension type headaches and migraine impose huge socioeconomic impact on society. The role of non-pharmacological interventions in management of primary headaches is not entirely clear. Acupuncture is one of the most historical non pharmacological ways of treating migraine and tension type headaches. The evidence in support of its effectiveness however is conflicting. This review evaluates the available evidence regarding effectiveness of acupuncture for migraine and tension type headaches.

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Acupuncture in patients with tension-type headache: randomised controlled trial

Abstract: ISRCTN9737659.

Cited by 365 publications

References 19 publications

Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial

Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial

Acupuncture for Tension-Type Headache: a Multicentre, Sham-Controlled, Patient and Observer-Blinded, Randomised Trial

Acupuncture in Primary Headache Disorders; Review of the Evidence

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