Disease-Related Factors Associated with Acupuncture Response in Patients with Chronic Tension-Type Headache: A Secondary Analysis of A Randomized Controlled Trial

Wei Cao; Lu Wang; Ting-Hui Hou; Yun-Zhou Shi; Qian-Hua Zheng; Hui Zheng; Zi-Hao Zou; Di Qin; Qian Yang; Si-Jue Chen; Hai-Yan Wang; Xian-Jun Xiao; Ying Li

doi:10.1007/s11655-023-3615-2

Disease-Related Factors Associated with Acupuncture Response in Patients with Chronic Tension-Type Headache: A Secondary Analysis of A Randomized Controlled Trial

Chin J Integr Med. 2024 Jan 11. doi: 10.1007/s11655-023-3615-2. Online ahead of print.

Authors

Wei Cao¹, Lu Wang¹, Ting-Hui Hou¹, Yun-Zhou Shi¹, Qian-Hua Zheng¹, Hui Zheng¹, Zi-Hao Zou¹, Di Qin¹, Qian Yang¹, Si-Jue Chen¹, Hai-Yan Wang¹, Xian-Jun Xiao², Ying Li³

Affiliations

¹ Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China.
² Acupuncture and Moxibustion School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China.
³ Department of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China. liying@cdutcm.edu.cn.

PMID: 38206534
DOI: 10.1007/s11655-023-3615-2

Abstract

Objective: To explore the demographic and disease-related factors associated with acupuncture response in patients with chronic tension-type headache (CTTH).

Methods: Using data from a randomized clinical trial (218 cases) consisting of 4 weeks of baseline assessment, 8 weeks of treatment, and 24 weeks of follow-up, participants were regrouped into responders (at least a 50% reduction in monthly headache days at week 16 compared with baseline) and non-responders. Twenty-three demographic and disease-related factors associated with acupuncture response in 183 participants were analyzed by multivariable logistic regression.

Results: One hundred and nineteen (65.0%) participants were classified as responders. Four factors were significantly independently associated with acupuncture response, including treatment assignment, headache intensity at baseline, and 2 domains [general health (GH) and social functioning (SF)] from the 36-Item Short Form Health Survey quality of life questionnaire. Treatment assignment was associated with non-response: participants receiving true acupuncture were 3-time more likely to achieve a CTTH response than those receiving superficial acupuncture [odds ratio (OR) 0.322, 95% confidence interval (CI) 0.162 to 0.625, P=0.001]. Compared with patients with mild-intensity headache, patients with moderate-intensity headache were twice as likely to respond to acupuncture (OR 2.001, 95% CI 1.020 to 4.011, P=0.046). The likelihood of non-response increased by 4.5% with each unit increase in the GH grade (OR 0.955, 95% CI 0.917 to 0.993, P=0.024) while decreased by 3.8% with each unit increase in the SF grade (OR 1.038, 95% CI 1.009 to 1.069, P=0.011).

Conclusions: Greater headache intensity, lower GH score, and higher SF score were associated with better acupuncture responses in CTTH patients. These 3 factors require independent validation as predictors of acupuncture effectiveness in CTTH.

Keywords: Chinese medicine; acupuncture; chronic tension-type headache; logistic regression; quality of life.