Comparison of Acupuncture and Sham Acupuncture in Migraine Treatment: An Overview of Systematic Reviews

Acupuncture is widely used for treating migraine; however, evidence of its efficacy when compared with sham acupuncture is equivocal. This study aimed to compare the evaluate efficacy of acupuncture versus sham acupuncture in migraine treatment. METHODS: We searched PubMed, the Cochrane Library, Web of Science, and EMBASE databases from their inception to April 25, 2021, for randomized controlled trials. The outcome measurement included response rate, migraine days, intensity, and frequency. RESULTS: Twenty randomized controlled trials involving 2725 patients were included. Pooled data suggested that acupuncture was superior to sham acupuncture [mean difference (MD)=−0.52, 95% confidence interval (CI): −0.71 to −0.34, P<0.00001] in reducing the migraine frequency after treatment and follow-up (MD=−0.51, 95% CI: −0.70 to −0.32, P<0.00001). In reducing Visual Analog Scale, acupuncture was superior to sham acupuncture (MD=−0.72, 95% CI: –1.17 to −0.27, P=0.002) after treatment, and also superior to sham acupuncture (MD=−0.82, 95% CI: −1.31 to −0.33, P=0.001) on the follow-up. As for responder rate, acupuncture’s efficacy was better than sham acupuncture (relative risk=1.28, 95% CI: 1.00-1.64, P=0.05). However, the reduction of migraine days in the acupuncture group was not significantly different from that in the sham acupuncture group after treatment (MD=−0.62; 95% CI: −1.31 to 0.08; P=0.08) and on the follow-up (MD=−0.68; 95% CI: −1.52 to 0.17; P=0.12). CONCLUSIONS: Acupuncture appears to be an effective treatment modality for migraine. Compared with sham acupuncture, acupuncture had greater improvements in migraine frequency, Visual Analog Scale, and responder rate, but there was no statistically significant difference for the number of migraine days.