Utility of Acupuncture Therapy for Adult Chronic Daily Headache Prophylaxis: A Systematic Review and Meta-Analysis

Yuxi Nie; Ruiyi Jing; Ziyi Song; Hong Zheng

doi:10.12659/MSM.952359

24 May 2026 : Meta-Analysis

Utility of Acupuncture Therapy for Adult Chronic Daily Headache Prophylaxis: A Systematic Review and Meta-Analysis

Yuxi Nie^{ABCDEFG 1}, Ruiyi Jing^{ABCDEFG 2}, Ziyi Song^{DEF 1}, Hong Zheng^{DEG 1*}

DOI: 10.12659/MSM.952359

Med Sci Monit 2026; 32:e952359

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Table 3 Subgroup analysis of outcomes by treatment modality, chronic daily headache (CDH) subtype, and treatment duration.

Outcome	Studies	Number of participants	Heterogeneity		Meta analysis		Subgroup differences
Outcome	Studies	Number of participants	P value	I2	Effect estimate (95%CI)	P value	Subgroup differences


	7	398	0.42	1%	−0.32 [−0.52, −0.12]	0.001	0.66
Acupuncture vs WCM	2	163	0.89	0%	−0.23 [−0.54, 0.07]	0.14
Acupuncture plus vs WCM	1	34			−0.22 [−0.89, 0.46]	0.53
Acupuncture vs placebo	4	201	0.16	42%	−0.42 [−0.70, −0.13]	0.004
	12	826	0.004	59%	−0.72 [−0.96, −0.48]	<0.00001	0.42
Acupuncture vs WCM	5	244	0.45	0%	−0.75 [−1.01, −0.49]	<0.00001
Acupuncture plus vs WCM	3	142	0.0001	89%	−0.71 [−1.06, −0.35]	<0.0001
Acupuncture vs placebo	4	140	0.33	13%	−0.55 [−0.74, −0.35]	<0.00001
	17	1091	<0.00001	89%	−0.63 [−1.01, −0.26]	0.001	0.51
Acupuncture vs WCM	3	185	<0.00001	97%	−1.44 [−3.31, 0.43]	0.13
Acupuncture plus vs WCM	4	176	0.02	69%	−0.62 [−1.18, −0.06]	0.03
Acupuncture vs placebo	10	730	<0.00001	84%	−0.42 [−0.80, −0.03]	0.04
	9	525	<0.00001	90%	−1.18 [−1.77, −0.58]	0.0001	0.02
Acupuncture vs WCM	4	182	<0.00001	93%	−2.23 [−3.71, −0.75]	0.003
Acupuncture plus vs WCM	1	60			−0.11 [−0.61, 0.40]	0.67
Acupuncture vs placebo	4	283	0.36	6%	−0.52 [−0.77, −0.27]	<0.0001
	9	431	0.06	46%	−0.51 [−0.78, −0.24]	0.0002	0.006
Acupuncture vs WCM	3	187	0.99	0%	−0.74 [−1.04, −0.44]	<0.0001
Acupuncture plus vs WCM	2	68	0.77	0%	0.16 [−0.31, 0.64]	0.50
Acupuncture vs placebo	4	176	0.19	37%	−0.59 [−0.97, −0.20]	0.003

	7	398	0.42	1%	−0.32 [−0.52, −0.12]	0.001	0.16
CDH	2	99	0.62	0%	−0.08 [−0.47, 0.32]	0.69
CTTH	5	299	0.43	0%	−0.41 [−0.64, −0.18]	0.0006
	12	826	0.004	59%	−0.63 [−0.77, −0.49]	<0.00001	0.70
CM	7	340	0.005	67%	−0.67 [−0.89, −0.44]	<0.00001
CTTH	5	486	0.07	54%	−0.61 [−0.79, −0.42]	<0.00001
	17	1091	<0.00001	89%	−0.35 [−0.47, −0.22]	<0.00001	0.18
CDH	2	99	0.02	81%	−0.56 [−0.97, −0.15]	0.0003
CM	4	202	0.08	55%	−0.52 [−0.80, −0.24]	0.0003
CTTH	11	790	<0.00001	92%	−0.27 [−0.42, −0.12]	0.0003
	9	525	<0.00001	90%	−0.74 [−0.92, −0.55]	0.0001	0.10
CM	4	196	<0.00001	95%	−0.88 [−1.20, −0.56]	<0.00001
CTTH	5	329	0.0003	81%	−0.67 [−0.90, −0.44]	<0.00001
	9	431	0.06	46%	−0.52 [−0.71, −0.32]	<0.00001	0.47
CDH	1	34			−0.83 [−1.54, −0.13]	0.02
CM	4	204	0.19	37%	−0.57 [−0.86, −0.29]	<0.0001
CTTH	4	193	0.04	65%	−0.40 [−0.69, −0.11]	0.006

	7	398	0.42	1%	−0.32 [−0.52, −0.12]	0.001	0.63
≤1 month	3	199	0.82	0%	−0.27 [−0.55, 0.01]	0.05
1 month	4	199	0.14	45%	−0.37 [−0.65, −0.09]	0.01
	12	826	0.004	59%	−0.63 [−0.77, −0.49]	<0.00001	0.26
≤1 month	7	314	0.001	72%	−0.78 [−1.01, −0.54]	<0.00001
1 month	3	390	0.24	30%	−0.52 [−0.72, −0.32]	<0.00001
>2 month	2	122	0.87	0%	−0.64 [−1.01, −0.28]	0.0006
	17	1091	<0.00001	89%	−0.63 [−1.01, −0.26]	0.001	0.07
≤1 month	9	473	<0.00001	89%	−0.95 [−1.54, −0.35]	0.002
1 month	8	618	<0.00001	81%	−0.28 [−0.68, 0.12]	0.17
	9	525	<0.00001	90%	−1.18 [−1.77, −0.58]	0.0001	0.1
≤1 month	5	232	<0.00001	93%	−1.85 [−3.08, −0.61]	0.003
1 month	3	233	0.27	23%	−0.49 [−0.79, −0.19]	0.002
>2 month	1	60			−0.42 [−0.94, 0.09]	0.1
	9	431	0.06	46%	−0.51 [−0.78, −0.24]	0.0002	0.35
≤1 month	5	267	0.30	18%	−0.61 [−0.88, −0.33]	<0.0001
1 month	3	102	0.07	63%	−0.17 [−0.82, 0.48]	0.61
>2 month	1	62			−0.76 [−1.28, −0.25]	0.004


	3	202	0.07	62%	−0.47 [−0.94, −0.00]	0.05	0.50
Acupuncture vs WCM	2	163	0.17	47%	−0.65 [−1.09, −0.22]	0.003
Acupuncture vs placebo	1	39			0.01 [−0.62, 0.64]	0.98
	8	595	0.04	52%	−0.70 [−0.96, −0.43]	<0.00001	0.001
Acupuncture vs WCM	3	124	0.86	0%	−1.27 [−1.67, −0.88]	<0.00001
Acupuncture plus vs WCM	3	142	0.62	0%	−0.38 [−0.71, −0.04]	0.03
Acupuncture vs placebo	2	329	0.81	0%	−0.54 [−0.76, −0.32]	<0.00001
	8	635	<0.00001	94%	−1.10 [−1.85, −0.35]	0.004	0.43
Acupuncture vs WCM	2	125	<0.00001	99%	−5.98 [−15.33, 3.37]	0.21
Acupuncture plus vs WCM	3	142	0.30	18%	−0.22 [−0.59, 0.15]	0.24
Acupuncture vs placebo	3	368	0.38	0%	−0.33 [−0.54, −0.13]	0.002
	5	293	<0.00001	94%	−1.83 [−3.02, −0.64]	0.003	<0.00001
Acupuncture vs WCM	3	122	0.05	67%	−2.90 [−3.83, −1.96]	<0.00001
Acupuncture plus vs WCM	1	111			−0.39 [−0.76, −0.01]	0.04
Acupuncture vs placebo	1	60			−0.27 [−0.78, 0.23]	0.29
	6	305	0.003	72%	−0.60 [−1.05, −0.16]	0.007	0.0003
Acupuncture vs WCM	2	122	0.31	3%	−1.27 [−1.67, −0.87]	<0.0001
Acupuncture plus vs WCM	3	144	1.00	0%	−0.23 [−0.56, 0.10]	0.16
Acupuncture vs placebo	1	39			−0.33 [−0.96, 0.31]	0.31

	3	202	0.07	62%	−0.47 [−0.94, −0.00]	0.05
CTTH	3	202	0.07	62%	−0.47 [−0.94, −0.00]	0.05
	8	595	0.04	52%	−0.63 [−0.80, −0.47]	<0.00001	0.84
CM	5	220	0.07	53%	−0.64 [−0.91, −0.36]	<0.00001
CTTH	3	375	0.05	67%	−0.63 [−0.84, −0.42]	<0.00001
	8	635	<0.00001	94%	−1.10 [−1.85, −0.35]	0.004	0.01
CM	3	142	0.30	18%	−0.22 [−0.59, 0.15]	0.24
CTTH	5	493	<0.00001	96%	−1.90 [−3.09, −0.71]	0.002
	5	293	<0.00001	94%	−1.83 [−3.02, −0.64]	0.003	0.47
CM	3	136	<0.00001	96%	−2.30 [−4.65, 0.04]	0.05
CTTH	2	157	<0.00001	94%	−1.23 [−2.94, 0.48]	0.16
	6	305	0.003	72%	−0.60 [−1.05, −0.16]	0.007	0.04
CM	3	144	1	0%	−0.23 [−0.56, 0.10]	0.16
CTTH	3	161	0.03	72%	−0.98 [−1.61, −0.34]	0.003

	3	202	0.07	62%	−0.47 [−0.94, −0.00]	0.05	0.50
≤1 month	2	163	0.17	47%	−0.65 [−1.09, −0.22]	0.003
1 month	1	39			0.01 [−0.62, 0.64]	0.98
	8	595	0.04	52%	−0.63 [−0.80, −0.47]	<0.00001	0.21
≤1 month	6	266	0.02	62%	−0.75 [−1.01, −0.50]	<0.00001
1 month	2	329	0.81	0%	−0.54 [−0.76, −0.32]	<0.00001
	8	635	<0.00001	94%	−1.10 [−1.85, −0.35]	0.004	0.03
≤1 month	5	267	<0.00001	96%	−2.12 [−3.69, −0.54]	0.0008
1 month	3	368	0.38	0%	−0.33 [−0.54, −0.13]	0.002
	5	293	<0.00001	94%	−1.83 [−3.02, −0.64]	0.003	0.03
≤1 month	4	182	<0.00001	94%	−2.24 [−3.86, −0.63]	0.006
1 month	1	111			−0.39 [−0.76, −0.01]	0.04
	6	305	0.003	72%	−0.60 [−1.05, −0.16]	0.007	0.34
≤1 month	5	266	0.002	76%	−0.66 [−0.91, −0.41]	<0.00001
1 month	1	39			−0.33 [−0.96, 0.31]	0.31

	3	202	0.07	62%	−0.47 [−0.94, −0.00]	0.05
≤3 month	3	202	0.07	62%	−0.47 [−0.94, −0.00]	0.05
	8	595	0.04	52%	−0.63 [−0.80, −0.47]	<0.00001	0.33
≤3 month	3	138	0.05	66%	−0.79 [−1.14, −0.43]	<0.0001
>3 month	5	457	0.10	49%	−0.59 [−0.78, −0.40]	<0.00001
	8	635	<0.00001	94%	−1.10 [−1.85, −0.35]	0.004	0.02
≤3 month	4	224	<0.00001	97%	−2.77 [−4.82, −0.72]	0.008
>3 month	4	411	0.43	0%	−0.30 [−0.50, −0.11]	0.002
	5	293	<0.00001	94%	−1.83 [−3.02, −0.64]	0.003	0.47
≤3 month	3	136	<0.00001	96%	−2.30 [−4.65, 0.04]	0.05
>3 month	2	157	<0.00001	94%	−1.23 [−2.94, 0.48]	0.16
	6	305	0.003	72%	−0.60 [−1.05, −0.16]	0.007	0.15
≤3 month	4	221	0.004	78%	−0.78 [−1.37, −0.18]	0.01
>3 month	2	84	0.94	0%	−0.24 [−0.67, 0.19]	0.28

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Utility of Acupuncture Therapy for Adult Chronic Daily Headache Prophylaxis: A Systematic Review and Meta-Analysis

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