Acupuncture Versus Propranolol On Comparison Of The Effects Of Preventing Migraine Attacks:An ITC Meta-Analysis Based On Bayesian Theory

Objective:Prophylactic treatment of migraine is still mainly based on pharmacological treatment,but non-pharmacological treatment,especially acupuncture in traditional Chinese medicine,has gradually received more and more attention.Propranolol,as a first-line drug,has not been compared directly in clinical trials to acupuncture therapy.Therefore,indirect comparison was performed through Bayesian ITC meta-analysis to explore the difference in efficacy between acupuncture and propranolol for migraine preventionMethod:Search for literature prior to February 2020 in PubMed,EMBASE and the Cochrane library.After initial screening,inclusion,exclusion,data extraction and bias assessment,data analysis was performed by R version 3.5.3,in which the loaded "gemtc" and rj ags packages were installed and used to complete the operation.The primary outcome measure was chosen as the responder rate and the secondary measures were chosen as the migraine frequency and migraine episodes to indirectly compare the efficacy of the two.Results:1.When responder rate was used as an outcome measure,information was interpreted from the relative forest plots when sham acupuncture and drug placebo were separated for analysis:there was no statistically significant difference in RR between acupuncture and propranolol[RR=1.5,95%Cl(0.84,2.7)].But in the rank probability,acupuncture ranked in the top three highest,in order of acupuncture>sham acupuncture>propranolol>placebo2.When migraine episodes were used as an outcome measure,acupuncture was significantly stronger in reducing migraine episodes than sham acupuncture,drug placebo,and waiting groups,but not significantly different from propranolol[MD=-1.2,95%CI(-2.8,0.28)].The rank probability is acupuncture>sham acupuncture>propranolol>placebo3.When the frequency of migraine was used as an outcome measure,there was no significant difference between acupuncture and propranolol[MD=-0.97,95%Cl(-3.3,1.5)],but both acupuncture and propranolol were significantly better than the placebo group.Calculate the probability ranking for reducing migraine frequency:acupuncture>sham acupuncture>propranolol>placeboConclusion:1.There was no statistically significant difference between the three measures of acupuncture and propranolol in the prophylactic treatment of migraine,but all three indicators of acupuncture were higher than propranolol when probability ranking was performed2.Both options are safe and patients can choose them according to their circumstances and preferences3.The effect of acupuncture in the prophylactic treatment of migraine is well established,with a number of outcome measures significantly better than those of the placebo,and significantly better than those of the sham acupuncture for migraine episodes.Future research should continue with more in-depth evidence-based medical research and exploration of the efficacy of acupuncture in chronic pain diseases.