| Objective:This study was conducted to observe the preventive effect of Soothing the Liver and Regulating the Spirit(SR)acupuncture on migraine attacks and regulation of mood in patients with menstrually related migraine accompanied by negative affect.Moreover,the study explored the possible mechanisms of SR acupuncture in treating menstrually related migraine.Methods:A total of 30 patients with menstrually related migraine and 30 healthy subjects were included in this study as the SR group and the healthy control group respectively.Patients with menstrually related migraine were treated with the SR acupuncture method for 2 consecutive menstrual cycles of 24±3 sessions,3 sessions per week.The number of perimenstrual headache days,the number of non-perimenstrual headache days,and the intensity of the peak headache were assessed at baseline(cycle 0),the intervention phase(cycles 1,2),and follow-up(cycles 3).The migrainespecific quality of life questionnaire(MSQ)was recorded at 1st(before treatment)and 3rd(after treatment)menstrual periods.The patient health questionnaire-9(PHQ-9)and the positive and negative affect scale(PANAS)were recorded at the patient’s 0th(before treatment)and 3rd(after treatment)menstrual periods.The PHQ-9 and PANAS scores of the healthy control group were recorded at their 0th(before observation)and 3rd(after observation)menstrual periods.Elbow venous blood of both groups at the 0th and 3rd menstrual periods was collected,and plasma levels of plasma estradiol(E2),5-hydroxytryptamine(5-HT),5-hydroxy indoleacetic acid(5-HIAA),3-methyl-4-hydroxyphenylglycol(MHPG),and homovanillic acid(HVA)were detected.Results:1.A total of 30 subjects were included in this study.Twenty-six patients completed the intervention and follow-up,the data of which was included in the analysis,while 4 patients were lost to follow-up.Thirty subjects were included in the healthy control group.The data of 27 healthy subjects were included in the analysis,while 3 subjects dropped out.The overall drop-out rate was 11.67%.No serious adverse events occurred during the trial.2.Baseline data including demographic characteristics,vital signs,and menstruation history were comparable between the SR group and the healthy control group.3.After the acupuncture treatment,the number of perimenstrual headache days,the number of non-perimenstrual headache days,and the headache intensity all decreased significantly(P<0.01)at cycle 3 compared with cycle 0.All 3 dimensions of the MSQ score,including role functionrestrictive(RR)(P<0.01),role function-preventive(RP)(P<0.01),and emotional function(EF)(P<0.01)scores,were significantly higher after treatment compared to baseline.4.At baseline,the PHQ-9 score of the SR group was higher than the healthy control group(P<0.01).Additionally,the positive affect score was lower(P<0.01),the negative affect score was higher(P<0.01),and the positive rate was significantly lower(P<0.01)in the SR group compared with the healthy control group.After treatment,the PHQ-9 score of the patients decreased(P<0.01).Similarly,the positive affect score(P<0.01)and the positive rate(P<0.01)increased,and the negative affect score decreased significantly(P<0.01)in patients.5.There was no statistically significant difference between the E2 levels in the patients and the healthy control group before treatment(P>0.05);in the SR group,the E2 level after treatment was not different from baseline(P>0.05),but there was a tendency to increase.Before treatment,the plasma 5-HT level in the SR group was lower than that in the healthy control group(P<0.01);it increased after treatment,though the difference was not significant(P>0.05).The plasma 5-HIAA level in the SR group was lower than that in the healthy control group before treatment(P<0.01);while it increased after treatment(P<0.05).At baseline,MHPG and HVA levels were higher in the SR group than in the healthy control group(P<0.01);after treatment,MHPG and HVA levels did not change significantly(P>0.05).6.Correlation analysis showed a weak negative correlation between plasma E2 and 5-HT in the healthy control group(P<0.05);a weak positive correlation between changes of E2 and MHPG before and after treatment in the SR group(P<0.05),and a weak negative correlation between the change of perimenstrual headache days and variation in 5-HIAA level after treatment(P<0.05).Conclusion:1.SR acupuncture method can reduce the number of perimenstrual and nonperimenstrual headache days in menstrually related migraineurs with negative affect to exert the preventive effect.Besides,the method can reduce the migraine intensity and improve patients’ migraine-related quality of life.2.SR acupuncture method can improve the emotional state of patients with menstrually related migraine,including relieving depression and promoting the transformation of negative affect into positive ones.3.SR tends to elevate E2,5-HT,and 5-HIAA.E2 may work together with MHPG.The decrease in the number of perimenstrual headache days may be related to the variation in 5-HIAA.4.Patients with menstrually related migraine tend to have lower plasma E2,5-HT,and 5-HIAA levels,but higher MHPG and HVA levels than healthy controls.It is possible that menstrually related migraineurs have variations in estrogen and monoamines compared to healthy controls. |
