[Optimized schemes for acupuncture treatment of migraine during attack]

To observe the therapeutic effect of manual acupuncture, electroacupuncture (EA), auricular acupuncture and bloodletting therapies combined with orthogonal design for migraine patients, so as to select a better scheme for relieving headache.

total of 76 migraine patients in the stage of attack were recruited in the present study and randomly (stratified random and central random) allocated to 9 groups by means of orthogonal experimental design [L9 (3(4)), 4 factors (F) and three levels (L)] i.e., F1: ody-acupoints combination; F1-L1: regional acupoints [Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5), etc.] near the focus, F1-L2:regional +distal acupoints [Hegu (L 4), Taichong (LR 3), etc.] far from the focus, and F1-L3:regional + remote acupoints+ those selected according to syndrome differentiation [for instance, Ganshu (BL 18), Yanglingquan (GB 34), Qiuxu (GB 40) and Taixi (KI 3) for hyperactivity of Liver-yang, etc.]; F2: manual acupuncture or EA of body acupoints; F2-L1:no acupuncture stimulation, F2-L2:manual acupuncture stimulation, and F2-L3:manual + EA stimulation; F3: auricular acupuncture therapy; F3-L1:no acupuncture stimulation, F3-L2: otopoint-manual acupuncture (Shenmen, Jiaogan, etc.), and F3-L3:otopoint-EA; F4: bloodletting; F4-L1 : EX-HN 5 + Ashi point bloodletting, F4-L2:EX-HN5 bloodletting, and F4-L3: no bloodletting. The therapeutic effect of acupuncture was evaluated using Visual Analogue Scale (VAS) and analyzed by investigators who did not participate in the treatment course.

Within 24 hours after the treatment, the four factors influencing headache relief from bigger to smaller are body-acupoints combination > manual acupuncture or EA stimulation > bloodletting > auricular acupuncture. Among the therapeutic schemes evaluated by orthogonal deduction, the analgesic effect was most stable in the manual acupuncture at regional + distal acupoints group which was recommended to be the ba-sic scheme for migraine. The auricular EA could effectively reduce VAS levels from 10 min to 30 min after stimulation, while bloodletting at Taiyang (EX-HN 5)+ Ashi points was effective in relieving migraine from 4 h to 24 h after the treatment, suggesting a long lasting post-therapeutic analgesic effect.

Manual acupuncture stimulation of the local + distal body acupoints combined with otopoint-EA and bloodletting at Taiyang (EX-HN 5) + Ashi points is the best option for relieving migraine during attack.