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Pain and Therapy

Open Access 15-05-2024 | Tension Headache | REVIEW

Tension-Type Headache Management: A Systematic Review and Network Meta-analysis of Complementary and Alternative Medicine

Authors: Lingli Qin, Ping Song, Xian Li, Longhui Yang, Feng Xu, Xueying Zhu, Lizhen Cai, Guangdi Hu, Weijia Sun, Yunling Zhang, Lu Zhang

Published in: Pain and Therapy

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Abstract

Introduction

Tension-type headache (TTH) is common but challenging to manage due to limited effectiveness of conventional treatments. This study examines six complementary and alternative medicine (CAM) interventions through network meta-analysis to identify effective TTH management strategies.

Methods

We searched PubMed, Embase, Web of Science, Cochrane Library, OVID, CNKI, Wanfang, VIP, and CBM databases for randomized controlled trials on CAM for TTH treatment. Headache frequency and intensity were the primary outcomes. Methodological quality was evaluated on the basis of the Cochrane risk of bias tool. We used R software to conduct this Bayesian network meta-analysis. We used mean difference (MD) with 95% credible intervals (CI) to calculate the continuous outcomes and analyzed the percentages of the surface under the cumulative ranking (SUCRA) curve.

Results

In total, 32 randomized controlled trials (RCTs) with 2405 participants were analyzed. For reducing headache intensity, the network meta-analysis shows that acupuncture therapy combined with traditional Chinese medicine (AT_TCM), manual therapy (MT), psychological treatment (PT), and traditional Chinese medicine combined with acupuncture and manual therapy (TCM_AT_MT) are superior to Western medicine (WM). In the SUCRA curve, TCM_AT_MT is the best for reducing headache frequency (HF).

Conclusions

This review, assessed as low-quality evidence by GRADE, cautiously suggests potential benefits of PT over other CAM interventions for TTH and indicates TCM_AT_MT might better reduce HF. It proposes that combining CAM interventions could enhance outcomes. Due to the preliminary nature of these findings, further high-quality RCTs are essential to confirm these suggestions and provide clearer clinical guidance.

PROSPERO Registration Number

CRD42021252073.
Appendix
Available only for authorised users
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Metadata
Title
Tension-Type Headache Management: A Systematic Review and Network Meta-analysis of Complementary and Alternative Medicine
Authors
Lingli Qin
Ping Song
Xian Li
Longhui Yang
Feng Xu
Xueying Zhu
Lizhen Cai
Guangdi Hu
Weijia Sun
Yunling Zhang
Lu Zhang
Publication date
15-05-2024
Publisher
Springer Healthcare
Published in
Pain and Therapy
Print ISSN: 2193-8237
Electronic ISSN: 2193-651X
DOI
https://doi.org/10.1007/s40122-024-00600-x
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