Objective To assess the effectiveness of acupuncture for tension-type headache. Methods A systematic review of the relevant randomized controlled trials (RCTs) of acupuncture for tension-type headache was performed using the methods of The Cochrane Collaboration. Trials were collected from The Cochrane Library, Issue 4, 2003, MEDLINE (1966 to March 2004), CBM (1978 to August 2003), VIP (1989 to April 2003) and handsearched all related articles published in Chinese in 2003. The quality of literature was reviewed, and data were extracted by two reviewers independently. Meta-analysis was conducted using RevMan 4.2 software. Results Thirteen RCTs involving 571 patients were included, of the thirteen RCTs, six were of high methodological quality according to Jadad scale (the Jadad score≥3), and “sham acupuncture” was used as controlled intervention in eight trials. Meta-analysis indicated that no statistical difference was detected between acupuncture and sham acupuncture groups on effectiveness with RR 1.55, 95%CI 0.97 to 2.47 and P=0.07 at the end of treatment. No statistical difference was detected between acupuncture and sham acupuncture groups on visual analogue scale at the end of treatment with WMD －0.55, 95%CI －1.20 to 0.09 and P=0.09; at the end of follow-up of less than 2 months with WMD －0.22, 95%CI －0.87 to 0.42 and P= 0.50 and at the end of follow-up of more than 2 months with WMD －0.65, 95% CI －1.41 to 0.11 and P=0.09. Conclusions Comparing acupuncture with sham acupuncture and other treatments, current evidence can not evaluate whether acupuncture is significantly effective for tension-type headache, more RCTs of high methodological quality are required.
Objetive To analyze the burden of disease and changing trends of tension-type headache (TTH) in China and globally from 1990 to 2021. MethodsBased on the latest global burden of disease (GBD) 2021 data, the incidence, prevalence, disability-adjusted life years (DALYs), and age-standardised incidence rate (ASIR), age-standardised prevalence rate (ASPR) and age-standardised disability-adjusted life year rate (ASDR) of TTH as the indicators for disease burden assessment. And trends were analyzed by average annual percent change (AAPC). In-depth analysis was carried out by combining socio-demographic index (SDI), frontier analysis, and decomposition analysis methods. ResultsDuring the period from 1990 to 2021, the ASIR of TTH in China increased from 6 467.407 per 100 000 to 6 851.134 per 100 000 (AAPC=12.028%), the ASPR rose from17 174.483 per 100 000 to 18 525.067 per 100 000 (AAPC=42.680%), and the ASDR increased from 41.791 per 100 000 to 43.498 per 100 000 (AAPC=0.052%). In contrast, the global ASIR of TTH declined from 8 960.345 per 100 000 to 8 931.311 per 100 000 (AAPC=?1.004%), the ASPR decreased from 24 904.846 per 100 000 to 24 764.722 per 100 000 (AAPC=?4.905%), and the ASDR dropped from 56.989 per 100 000 to 55.694 per 100 000 (AAPC=?0.042%). Gender differences revealed that all disease burden indicators were consistently higher in females than those in males. However, in China, the rates of increase in these indicators were more significant among males. The crude incidence and prevalence rates exhibited a bimodal age distribution. ConclusionThe disease burden of TTH in China has demonstrated a significant upward trend, with notable disparities by gender and age.