| Objective:To take acupuncture as an intervention method in patients with acute migraine without aure(MwoA),and use a randomized,controlled,double-simulation study to evaluate the immediate clinical efficacy and follow-up efficacy of acupuncture in the treatment of acute MwoA;to explore the analgesic effect of acupuncture on acute MwoA and its possible internal mechanism,and provide evidence-based evidence for the treatment of acute MwoA with acupuncture.Methods:Through dual simulation research technology,sixty patients with acute MwoA were completely randomly divided into treatment group and control group,with 30 cases in each group,in the treatment group 1 case was losed.The treatment group received acupuncture at Baihui,Shenting,Bilateral Fengchi,and Taiyang,Shuaigu,Touwei points and oral ibuprofen placebo treatment;the control group received oral ibuprofen tablets and sham acupuncture non-acupoint treatment,compare the two groups before treatment,20 min after treatment,40 min after treatment,1h after treatment,2h after treatment,6h after treatment,12 h after treatment,24 h after treatment,with visual analogue score(VAS),accompanying symptom score,emotional score,current pain status score,and enzyme-linked immunosorbent assay(ELISA)to detect serum CGRP,SP,TNF-ɑ,IL-1β before and after treatment.Results:1.The influence of acupuncture on the VAS score:(1)Comparison within the group:The VAS scores of the two groups after treatment were compared with those before treatment,and all time points after treatment were significantly lower than before treatment(P < 0.01).(2)Comparison between groups:Comparing the VAS scores between the two groups at 20 min and 40 min after treatment,the treatment group decreased significantly(P<0.01);there was no variance in the VAS scores between the two groups at 1h,2h,6h,12 h,and 24 h after treatment(P> 0.05);the results of repeated measurement analysis of variance showed that the time factor has an impact on VAS(P<0.01),and there is an interaction between the group and the time factor(P<0.01).2.The influence of acupuncture on the accompanying symptom score:(1)Comparison within the group:Compared the time untreated,the accompanying symptom scores of the treatment group at various time points after treatment were significantly lower than those previous treatment(P < 0.01);the control group 20 min after treatment was compared with those before treatment,there was no significant change,and the difference was not statistically significant(P > 0.05).The accompanying symptom scores of 40 min after treatment,1 h after treatment,2 h after treatment,6 h after treatment,12 h after treatment,and 24 h after treatment were all significantly lower than before treatment(P < 0.01).(2)Comparison between groups:Comparing the accompanying symptom scores of the two groups at 20 min and 1h after treatment,the decrease in the treatment group was statistically significant(P < 0.05).Comparing the accompanying symptom scores between the groups at 40 min after treatment,the treatment group reduced significantly(P<0.01);After 2 h,6 h after treatment,12 h after treatment,and 24 h after treatment,there was no statistically significant difference in the accompanying symptom scores(P>0.05);after testing,the time factor had an effect on the scores of accompanying symptoms(P<0.01),and there was an interaction between group and time factors(P<0.01).3.The influence of acupuncture on the emotion score:(1)Comparison within the group:The emotional score of the treatment group at all time points after treatment was significantly decreased than that before treatment(P < 0.01);compared with before treatment,the emotional scores of the control group at 40 min after treatment,1 h after treatment,2 h after treatment,6 h after treatment,12 h after treatment,and 24 h after treatment decreased significantly(P<0.01),and there was no significant difference in emotion scores at 20 min after treatment(P > 0.05).(2)Comparison between groups:Comparing the emotional scores of the two groups,the reduction at 20 minutes after treatment in the treatment group was statistically significant(P <0.05);comparing the emotional scores between the two groups,the reduction at 40 minutes after treatment in the treatment group was more significant(P<0.01);the two groups 1 h after treatment and 2 h after treatment,6 h after treatment,12 h after treatment,and 24 h after treatment,there was no statistically significant difference in emotion scores(P>0.05);the test results showed that the time factor has an influence on the emotion score(P<0.01),there is an interaction between factors of group and time(P<0.01).4.The influence of acupuncture on the current pain status score:(1)Comparison within the group: Compared with before treatment,the current pain status score of the treatment group at all time points after treatment was significantly lower than that before treatment(P<0.01);the current pain status score of the control group at 40 min after treatment,1 h after treatment,2 h after treatment,6 h after treatment,12 h after treatment,and 24 h after treatment decreased significantly compared with before treatment,,the difference was statistically significant(P < 0.01),the change in current pain score at 20 min after treatment was not remarkable(P > 0.05).(2)Comparison between groups:Comparing the current pain scores of the two groups 20 minutes after treatment,40 minutes after treatment,the treatment group decreased statistically(P<0.05 and P<0.01);there were no statistically significant differences in the current pain scores of the two groups at 1h after treatment,2h after treatment,6h after treatment,12 h after treatment,and 24 h after treatment(P>0.05).The test results show that the time factor has an impact on the current pain status(P<0.01),and there is an interaction between the group and the time factor(P<0.01).5.ELISA detection of serum CGRP,SP,TNF-ɑ,IL-1β levels: compared with before treatment,the indexes of the two groups after treatment were lower than before(P<0.05);after treatment,the indexes of the treatment group decreased with Statistically significant(P < 0.05),among which CGRP and SP decreased more significantly(P<0.01).6.The results of the immediate curative effect: At 20 min and 40 min after treatment,comparison between the two groups showed that the curative effect of the treatment group was significantly better than that of the control group(P<0.01);at 1 h and 2 h after treatment,the treatment group and the control group had similar curative effects,the difference was not statistically significant(P>0.05).7.Conclusion:1.Acupuncture effectively reduces the VAS score,accompanying symptom score,emotional score,and current pain score in patients with MwoA in the acute phase.It can take effect early at 20 minutes after treatment.The effect is significant at 40 minutes after treatment,and the effect is stable at 1 hour after treatment.It is combined with ibuprofen at 2 hours.The curative effect is equivalent,and the follow-up curative effect is stable,suggesting that it has obvious immediate analgesic effect,and has a good therapeutic effect on pain intensity,accompanying symptoms and emotional disorders.Compared with ibuprofen,it can achieve similar curative effect but has more effective effect.Because of its rapid characteristics,it is more suitable for early intervention and treatment of acute MwoA.2.Acupuncture reduces serum levels of CGRP,SP,TNF-ɑ,and IL-1β,suggesting that its mechanism for the treatment of acute MwoA may be related to reducing the release of neuropeptides and inflammatory factors in the trigeminal ganglion,inhibiting the neurogenic inflammation of the meninges and the activation of the trigeminal pain pathway,thereby playing an anti-migraine effect. |
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