Systematic Review on Randomized Controlled Clinical Trials of Acupuncture Therapy for Neurovascular Headache

Objective：To evaluate the effectiveness of acupuncture as a treatment for neurovascular headache and to analyze the current situation related to acupuncture treatment.Methods：PubMed database （1966-2010）,EMBASE database（1986-2010）,Cochrane Library（Issue 1,2010）,Chinese Biomedical Literature Database（1979-2010）,China HowNet Knowledge Database（1979-2010）,VIP Journals Database（1989-2010）, and Wanfang database（1998-2010） were retrieved.Randomized or quasi-randomized controlled studies were included.The priority was given to high-quality randomized,controlled trials.Statistical outcome indicators were measured using RevMan 5.0.20 software.Results：A total of 16 articles and 1 535 cases were included. Meta-analysis showed a significant difference between the acupuncture therapy and Western medicine therapy [combined RR（random efficacy model）=1.46,95%CI（1.21,1.75）,Z=3.96,P0.0001],indicating an obvious superior effect of the acupuncture therapy;significant difference also existed between the comprehensive acupuncture therapy and acupuncture therapy alone[combined RR（fixed efficacy model）=3.35,95%CI （1.92,5.82）,Z=4.28,P0.0001],indicating that acupuncture combined with other therapies,such as points injection,scalp acupuncture,auricular acupuncture,etc.,were superior to the conventional body acupuncture therapy alone.Conclusions：The inclusion of limited clinical studies had verified the efficacy of acupuncture in the treatment of neurovascular headache.Although acupuncture or its combined therapies provides certain advantages,most clinical studies are of small sample sizes.Large sample size,randomized,controlled trials are needed in the future for more definitive results.

Study on pharmacological effect of Chuanxiong Rhizoma on vascular neuropathic headache

Chuanxiong Rhizoma is the dry rhizome of Ligusticum chuanxiong in the umbelliferae family.Chuanxiong Rhizoma pungent,warm,go to liver,gallbladder and pericardium.Effective in promoting blood circulation,promoting Qi,dispelling wind and relieving pain,it could treat chest pain,tingling pain in chest and flank,lump,irregular menstruation,amenorrhea,symptomatic abdominal pain,headache and rheumatic pain.Neurovascular headache is a primary disease caused by dysregulation of intracranial vascular movement and nerve function.It has the characteristics of long course,intermittent recurrent attacks,lingering and difficult to heal.Attacks are often accompanied by many plant nervous system symptoms,such as rapid breathing,accelerated heart rate,vomiting,and gastrointestinal dysfunction.Vascular nerve headache is a common clinical disease,frequently bidity.Studies have shown that Chuanxiong Rhizoma has good pharmacological effects in the treatment of vascular neuropathic headache.①The action of Qi and blood circulation:vascular and neurovascular headache is caused by the evil of external wind and cold and damp heat,which leads to the disconnection of the veins,the disorder of Qi and blood,the obstruction of Qi and blood channels,the loss of brain collateral,and finally causes migraine.Modern Chinese medicine points out that"wind,blood stasis,deficiency,phlegm"are the key factors of the disease.Chuanxiong Rhizoma is the medicine of Qi in the blood.It is pungent and warm.It is good at activating blood and promoting Qi,dispelling wind,relieving pain and dispelling cold,so as to achieve the effect of treating vascular headaches.②Improve brain circulation:angioneurotic headache is caused by dysfunction of the central nervous system related to the regulation of vascular movement,which causes vasospasm or extreme vasodilation,and the decrease of intracranial blood flow causes cerebral ischemia and hypoxia.Sodium ferulate is a chemical component in Chuanxiong Rhizoma.It has a relatively good inhibitory effect on platelet aggregation and the release of 5-HT from platelets.It can ensure the normal contraction of intracranial and extracranial blood vessels,improve the patient′s brain circulation and nerve function,so as to achieve the effect of treating angioneurotic headaches.③Sedative and analgesic effect:the volatile oil and water decoction of Chuanxiong Rhizoma have sedative and analgesic effects,and the water decoction can counteract the excitatory effect of caffeine.Studies have shown that the ATP activation current of rat dorsal root ganglion neurons can be inhibited by ligustrazine in a non-competitive way,which also indicates that Chuanxiong Rhizoma has a good analgesic effect.In this study,the effects of Chuanxiong Rhizoma on angoneeurotic headache were reviewed,and the pharmacological effects of Chuanxiong Rhizoma were further elucidated,providing basis for clinical application and new drug development of Chuanxiong Rhizoma in the treatment of angoneeurotic headache.