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Acupoint injection of onabotulinumtoxin A for migraines.

Hou M, Xie JF, Kong XP, Zhang Y, Shao YF, Wang C, Ren WT, Cui GF, Xin L, Hou YP - Toxins (Basel) (2015)

Bottom Line: Injection of a small amount of drug at acupuncture points is an innovation as compared to traditional acupuncture.The variations between baseline and BoNTA post-injection for four months were calculated monthly as outcome measures.BoNTA injections at fixed-sites and acupoint-sites significantly reduced the migraine attack frequency, intensity, duration and associated symptoms for four months compared with placebo (p < 0.01).

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroscience, Anatomy, Histology and Embryology, Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, 199 Donggang Xi Road, Lanzhou 730000, China. sunny_smile_824@163.com.

ABSTRACT
Onabotulinumtoxin A (BoNTA) has been reported to be effective in the therapy for migraines. Acupuncture has been used worldwide for the treatment of migraine attacks. Injection of a small amount of drug at acupuncture points is an innovation as compared to traditional acupuncture. The purpose of this study was to evaluate and compare the effectiveness of fixed (muscle)-site and acupoint-site injections of BoNTA for migraine therapy in a randomized, double-blinded, placebo-controlled clinical trial extending over four months. Subjects with both episodic and chronic migraines respectively received a placebo (n = 19) or BoNTA (2.5 U each site, 25 U per subject) injection at fixed-sites (n = 41) including occipitofrontalis, corrugator supercilii, temporalis and trapeziue, or at acupoint-sites (n = 42) including Yintang (EX-HN3), Taiyang (EX-HN5), Baihui (GV20), Shuaigu (GB8), Fengchi (GB20) and Tianzhu (BL10). The variations between baseline and BoNTA post-injection for four months were calculated monthly as outcome measures. BoNTA injections at fixed-sites and acupoint-sites significantly reduced the migraine attack frequency, intensity, duration and associated symptoms for four months compared with placebo (p < 0.01). The efficacy of BoNTA for migraines in the acupoint-site group (93% improvement) was more significant than that in the fixed-site group (85% improvement) (p < 0.01). BoNTA administration for migraines is effective, and at acupoint-sites shows more efficacy than at fixed-sites. Further blinded studies are necessary to establish the efficacy of a low dose toxin (25 U) introduced with this methodology in chronic and episodic migraines.

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Related in: MedlinePlus

Schematic sites of acupoint-sites injection. These sites (●) are Yintang (EX-HN3), at the midpoint of the line connecting the two medial ends of eyebrows; Taiyang (EX-HN5), at the point of intersection of the continuations of the eyebrow and the lower eyelid in the lateral direction, on the lateral border of the orbit; Baihui (GV20), at the middle of the vertex, on the line connecting the apexes of the two ears; Shuaigu (GB8), directly above the ear apex, 1.5 inches above the hairline; Fengchi (GB20), at the posterior lateral aspect of the neck, in the fossa between the superior margins of the trapezius and sternocleidomastoid muscles; and Tianzhu (BL10), 1.3 inches lateral to the point 0.5 inches directly above the midpoint of the posterior hairline, in the depression lateral to the border of the trapezius muscle.
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toxins-07-04442-f002: Schematic sites of acupoint-sites injection. These sites (●) are Yintang (EX-HN3), at the midpoint of the line connecting the two medial ends of eyebrows; Taiyang (EX-HN5), at the point of intersection of the continuations of the eyebrow and the lower eyelid in the lateral direction, on the lateral border of the orbit; Baihui (GV20), at the middle of the vertex, on the line connecting the apexes of the two ears; Shuaigu (GB8), directly above the ear apex, 1.5 inches above the hairline; Fengchi (GB20), at the posterior lateral aspect of the neck, in the fossa between the superior margins of the trapezius and sternocleidomastoid muscles; and Tianzhu (BL10), 1.3 inches lateral to the point 0.5 inches directly above the midpoint of the posterior hairline, in the depression lateral to the border of the trapezius muscle.

Mentions: The injection sites in acupoint groups were respectively at Yintang (EX-HN3), Taiyang (EX-HN5), Baihui (GV20), Shuaigu (GB8), Fengchi (GB20) and Tianzhu (BL10), based on predetermined and well-known Chinese acupoints for the treatment of migraines (Figure 2) [51].


Acupoint injection of onabotulinumtoxin A for migraines.

Hou M, Xie JF, Kong XP, Zhang Y, Shao YF, Wang C, Ren WT, Cui GF, Xin L, Hou YP - Toxins (Basel) (2015)

Schematic sites of acupoint-sites injection. These sites (●) are Yintang (EX-HN3), at the midpoint of the line connecting the two medial ends of eyebrows; Taiyang (EX-HN5), at the point of intersection of the continuations of the eyebrow and the lower eyelid in the lateral direction, on the lateral border of the orbit; Baihui (GV20), at the middle of the vertex, on the line connecting the apexes of the two ears; Shuaigu (GB8), directly above the ear apex, 1.5 inches above the hairline; Fengchi (GB20), at the posterior lateral aspect of the neck, in the fossa between the superior margins of the trapezius and sternocleidomastoid muscles; and Tianzhu (BL10), 1.3 inches lateral to the point 0.5 inches directly above the midpoint of the posterior hairline, in the depression lateral to the border of the trapezius muscle.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663513&req=5

toxins-07-04442-f002: Schematic sites of acupoint-sites injection. These sites (●) are Yintang (EX-HN3), at the midpoint of the line connecting the two medial ends of eyebrows; Taiyang (EX-HN5), at the point of intersection of the continuations of the eyebrow and the lower eyelid in the lateral direction, on the lateral border of the orbit; Baihui (GV20), at the middle of the vertex, on the line connecting the apexes of the two ears; Shuaigu (GB8), directly above the ear apex, 1.5 inches above the hairline; Fengchi (GB20), at the posterior lateral aspect of the neck, in the fossa between the superior margins of the trapezius and sternocleidomastoid muscles; and Tianzhu (BL10), 1.3 inches lateral to the point 0.5 inches directly above the midpoint of the posterior hairline, in the depression lateral to the border of the trapezius muscle.
Mentions: The injection sites in acupoint groups were respectively at Yintang (EX-HN3), Taiyang (EX-HN5), Baihui (GV20), Shuaigu (GB8), Fengchi (GB20) and Tianzhu (BL10), based on predetermined and well-known Chinese acupoints for the treatment of migraines (Figure 2) [51].

Bottom Line: Injection of a small amount of drug at acupuncture points is an innovation as compared to traditional acupuncture.The variations between baseline and BoNTA post-injection for four months were calculated monthly as outcome measures.BoNTA injections at fixed-sites and acupoint-sites significantly reduced the migraine attack frequency, intensity, duration and associated symptoms for four months compared with placebo (p < 0.01).

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroscience, Anatomy, Histology and Embryology, Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, 199 Donggang Xi Road, Lanzhou 730000, China. sunny_smile_824@163.com.

ABSTRACT
Onabotulinumtoxin A (BoNTA) has been reported to be effective in the therapy for migraines. Acupuncture has been used worldwide for the treatment of migraine attacks. Injection of a small amount of drug at acupuncture points is an innovation as compared to traditional acupuncture. The purpose of this study was to evaluate and compare the effectiveness of fixed (muscle)-site and acupoint-site injections of BoNTA for migraine therapy in a randomized, double-blinded, placebo-controlled clinical trial extending over four months. Subjects with both episodic and chronic migraines respectively received a placebo (n = 19) or BoNTA (2.5 U each site, 25 U per subject) injection at fixed-sites (n = 41) including occipitofrontalis, corrugator supercilii, temporalis and trapeziue, or at acupoint-sites (n = 42) including Yintang (EX-HN3), Taiyang (EX-HN5), Baihui (GV20), Shuaigu (GB8), Fengchi (GB20) and Tianzhu (BL10). The variations between baseline and BoNTA post-injection for four months were calculated monthly as outcome measures. BoNTA injections at fixed-sites and acupoint-sites significantly reduced the migraine attack frequency, intensity, duration and associated symptoms for four months compared with placebo (p < 0.01). The efficacy of BoNTA for migraines in the acupoint-site group (93% improvement) was more significant than that in the fixed-site group (85% improvement) (p < 0.01). BoNTA administration for migraines is effective, and at acupoint-sites shows more efficacy than at fixed-sites. Further blinded studies are necessary to establish the efficacy of a low dose toxin (25 U) introduced with this methodology in chronic and episodic migraines.

Show MeSH
Related in: MedlinePlus