Objective To observe the therapeutic effect of manual acupuncture

electroacupuncture(EA)

auricular acu-puncture and bloodletting therapies combined with orthogonal design for migraine patients

so as to select a better scheme for relieving headache.Methods A total of 76 migraine patients in the stage of attack were recruited in the present study and randomly(stratified random and central random) allocated to 9 groups by means of orthogonal experimental design [L9(34)

4 factors(F) and three levels(L)].i.e.

F1:body-acupoints combination;F1-L1: regional acupoints [Sizhukong(TE 23)

Shuaigu(GB 8)

Taiyang(EX-HN 5)

etc.] near the focus

F1-L2:regional +distal acupoints [Hegu(LI 4)

Taichong(LR 3)

etc.] far from the focus

and F1-L3:regional +remote acupoints+those selected according to syndrome differentiation [for instance

Ganshu(BL 18)

Yanglingquan(GB 34)

Qiuxu(GB 40) and Taixi(KI 3) for hyperactivity of Liver-yang

etc.];F2: manual acupuncture or EA of body acupoints;F2-L1:no acupuncture stimulation

F2-L2:manual acupuncture stimulation

and F2-L3:manual+EA stimulation;F3: auricular acupuncture therapy;F3-L1:no acupuncture stimulation

F3-L2:otopoint-manual acupuncture(Shenmen

Jiaogan

etc.)

and F3-L3:otopoint-EA;F4: bloodletting;F4-L1: EX-HN 5+Ashi point bloodletting

F4-L2:EX-HN 5 bloodletting

and F4-L3: no bloodletting.The therapeutic effect of acupuncture was evaluated using Visual Analogue Scale(VAS) and analyzed by investigators who did not participate in the treatment course.Results Within 24 hours after the treatment

the four factors influencing headache relief from bigger to smaller are body-acupoints combination>manual acupuncture or EA stimulation>bloodletting>auricular acupuncture.Among the therapeutic schemes evaluated by orthogonal deduction

the analgesic effect was most stable in the manual acupuncture at regional+distal acupoints group which was recommended to be the ba-sic scheme for migraine.The auricular EA could effectively reduce VAS levels from 10 min to 30 min after stimulation

while bloodletting at Taiyang(EX-HN 5)+Ashi points was effective in relieving migraine from 4 h to 24 h after the treatment

suggesting a long lasting post-therapeutic analgesic effect.Conclusion Manual acupuncture stimulation of the local+distal body acupoints combined with otopoint-EA and bloodletting at Taiyang(EX-HN 5) +Ashi points is the best option for relieving migraine during attack.