The investigators conducted a multicenter, prospective, randomized controlled clinical study to learn whether fire needling combined with filiform needling applied to pericranial muscle tenderness areas can effectively treat chronic migraine with comorbid tension-type headache. The study will also evaluate the safety and long-term efficacy of this therapy. Its main target questions include:
1. Can fire needling significantly reduce the number of headache days per month? 2. What is the effect of this therapy on headache intensity, emotional symptoms, and quality of life? The investigators will compare "fire needling at pericranial tender points plus conventional filiform needling" versus "conventional filiform needling alone" to verify whether the key technique of fire needling plus conventional filiform needling provides unique additive value.
Participants will:
1. Receive treatment twice per week for 8 weeks (either in the experimental group or the control group)，attend a follow-up visit at week 24 after enrollment 2. Keep a headache diary (recording headache frequency, pain intensity, duration, associated symptoms, etc.) 3. Regularly complete assessments of emotional status, quality of life, and number of pericranial tender points
Meets the diagnostic criteria for tension-type headaches with pericranial tenderness;
Meets the diagnostic criteria for chronic migraine;
18 years ≤ age ≤ 65 years;
Has sufficient understanding to complete the necessary examinations and tests for the study;
Patients complicated with cluster headache or other primary headaches;
Patients with secondary headaches caused by intracranial space-occupying lesions, cranial infections, etc.;
Patients complicated with severe heart, liver or kidney impairment, coagulation disorders, infections, severe immunocompromise, or allergic predisposition;
Patients with alcohol or drug dependence;
Parallel
filiform needling
Procedure/SurgerySelection of acupoints for filiform needle therapy is integrated with the international standard acupuncture preventive treatment protocol for migraine specified in Acupuncture Clinical Practice Guidelines for Migraine issued by the World Federation of Acupuncture-Moxibustion Societies （WFAS 007.8-2023）.Treatment was administered twice weekly for 8 weeks. Main Acupoints: Baihui (GV20), Shenting (GV24), Fengchi (GB20, bilateral), Benshen (GB13, bilateral), Shuaigu (GB8, bilateral), Taiyang (EX-HN5, bilateral). Adjunct Acupoints: For shaoyang headache: add Toulinqi (GB15), Yangbai (GB14), Fubai (GB10), Zulinqi (GB41), Waiguan (SJ5), Yanglingquan (GB34); For yangming headache: add Touwei (ST8), Hegu (LI4), Neiting (ST44); For taiyang headache: add Kunlun (BL60), Houxi (SI3); For jueyin headache: add Taichong (LR3), Qiuxu (GB40).
fire needling combined with filiform needling
Procedure/SurgeryFire needling was used to puncture pericranial muscle tenderness areas (including the external occipital protuberance, superior nuchal line, nuchal plane, mastoid process; cervicoscapular areas; epicranial aponeurosis - frontal and temporal regions; upper trapezius, sternocleidomastoid, levator scapulae, temporalis, masseter, and occipitofrontalis muscles) in addition to filiform needling at meridian acupoints (same acupoints as the filiform needling group). Treatment was administered twice weekly for 8 weeks.
Treatment efficacy
Based on the statistics from the headache diaries completed by patients, it is defined as the proportion of subjects who achieve a reduction in headache days of ≥50% after treatment compared to before treatment.
Headache days
Headache Duration
Headache severity
The proportion of monthly headache attacks occurring ≤1 time per month
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Beijing Hospital of Traditional Chinese Medicine
Lead sponsor
Capital's Funds for Health Improvement and Research
Collaborator
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