Electroacupuncture for tension-type headache on distal acupoints only: a randomized, controlled, crossover trial

Xue, C. C.

Dong, L.

Polus, B.

English, R. A.

Zheng, Z.

Da Costa, C.

Li, C. G.

Story, D. F.

2004

44(4)

333-341

RCT

Electroacupuncture

Cross-Over Design

Acu Versus Sham

Headache Disorders

Pain

RCT

Semi-Individualized Acupuncture Protocol

Sham Control

TCM Acupuncture Style

TENS

Tension-Type Headache

Penetrating Sham

Superficial Needling Depth

Near Verum Acupoint Control

Transcutaneous Electric Nerve Stimulation

Traditional Diagnosis Based Point Selection

Restricted Modalities, Acupuncture Only

OBJECTIVE: To investigate the efficacy of electroacupuncture, applied to distal acupoints only, for tension-type headache. BACKGROUND: Electroacupuncture is commonly used for tension-type headache, but when applied to distal acupoints only, evidence of its efficacy is lacking. DESIGN: A randomized, single-blinded, sham-controlled, crossover clinical trial. Methods.-The trial had 5 stages: baseline (2 weeks), phases I and II (each 4 weeks), washout period (2 weeks), and follow-up (3 months after phase II). Forty patients were randomly assigned to either group A or group B. Group A received real electroacupuncture during phase I, then sham electroacupuncture in phase II. Group B received the treatments in reverse order. Outcome measures were headache frequency and duration, pain intensity using a visual analog scale, mechanical pain threshold, headache disability, and sickness impact. Data were analyzed by univariate 2-way analysis of variance. RESULTS: Thirty-seven patients completed the trial. There were no significant differences between the 2 groups at baseline. At the end of phase I, group A, but not group B, demonstrated significant improvement in mean (standard error of the mean [SEM]) headache frequency (3.0 per month [0.3] versus 12.0 per month [1.7]), duration (13.3 hours [3.5] versus 32.0 hours [6.2]), pain intensity (32.8 mm [4.1] versus 47.5 mm [2.7]), pain threshold (right side, 2.9 kg/second [0.1] versus 0.9 kg/second [0.1]; left side, 2.4 kg/second [0.1] versus 1.1 kg/second [0.1]), headache disability score (6.0 [1.0] versus 16.3 [1.6]), and sickness impact score (288.7 [48.0] versus 687.1 [77.2]). For each parameter, significant differences also were demonstrated for both groups between baseline and phase II, and baseline and follow-up. There were no significant differences between the groups at the end of follow-up (P >.05). CONCLUSION: Electroacupuncture to distal points alone is effective for short-term symptomatic relief of tension-type headache

Headache Disorders

>1/WK

40

4 Weeks