Issue 41

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Acupuncture May Be As Effective as Prophylactic Drug Therapy for the Prevention of Migraines

PROCEDURE PERFORMED AT MEDICAL WELLNESS ASSOCIATES BY EMMA McGOWAN, M.D. AND MARTIN GALLAGHER, M.D.

In a randomized controlled multi-center trial involving 114 patients who experience migraine headaches, treatment with acupuncture over the course of 12 weeks was found to be as effective as standard prophylactic drug therapy for the prevention of migraine headaches. The study began with a 4 week pre-randomization period, in which subjects recorded information about their headaches in a headache diary. Subjects were randomized into one of two groups. Group1 received 8-15 acupuncture treatments over the course of 12 weeks (points included some 'basic' points common to all patients: GB-20, GB-40 or 41, DU-20, LR-3, SJ-3 or 5, in addition to points determined for each subject individually based on their traditional Chinese syndrome diagnosis and the location of their pain), while Group2 received the commonly used, first-line drug for migraine prophylaxis, metoprolol (brand names: Lopressor, Toprol-XL), 100-200 mg/d over the course of the same 12 week period. Subjects were followed up with for an additional 12 weeks following the intervention period. Outcomes were primarily assessed based on the difference in the number of days with migraines before randomization as compared to the number of days with migraine between weeks 9-12 after randomization. While only 2 subjects randomized to acupuncture dropped out of the study, 18 subjects randomized to drug therapy dropped out (7 experienced intolerable side effects, 1 experienced worsening of symptoms, 7 refused to take the drug). The percentage of subjects who experienced at least a 50% reduction in migraine attacks was 61% for subjects who received acupuncture and 49% for subjects who received metoprolol. Furthermore, subjects who received acupuncture experienced a 2.5 day reduction in the number of days with migraines, while subjects who received metoprolol experienced a reduction of 2.2 days. Moreover, subjects who received acupuncture fared considerably better on the pain questionnaire. After 12 weeks, 70% of subjects in the acupuncture group reported global assessment to be "good" or "very good" compared to 45% of subjects in the metoprolol group, and after 24 weeks, global assessment was evaluated to be "good" or "very good" among 56% of subjects in the acupuncture group, versus 26% of subjects in the metoprolol group. Physicians reported overall global treatment success to be superior in the acupuncture group. The results of this study confirm findings from 2 previous published studies which compared acupuncture to drug therapy for migraine prophylaxis. The authors point out that their results must be interpreted with caution due to the high drop-out rate in the metoprolol group and the failure to meet their recruitment target. The authors conclude, "Despite a number of shortcomings this trial adds to the growing body of evidence that acupuncture might be an effective and safe treatment option and, thus, could be a helpful tool for the interval treatment of migraine, particularly in patients unwilling or unable to use drug prophylaxis."

"Effectiveness and tolerability of acupuncture compared with metoprolol in migraine prophylaxis," Streng A, Linde K, et al, Headache, 2006; 46(10): 1492-502. (Address: Dr. Andrea Streng, Centre for Complimentary Medicine Research, Department of Internal Medicine II, Technische Universitat Munchen, Kaiserstr, 9, 80801, Munich, Germany).

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Did you know.......

CHINESE CABBAGE

  • Chinese cabbage has anti-inflammatory properties
  • It is an excellent source of folic acid
  • Chinese cabbage is low in calories and low in sodium
  • It is also high in vitamin A and a good source of potassium

 

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