针灸治疗头痛的研究进展与临床应用

Research Progress and Clinical Applications of Acupuncture in Headache Treatment

摘要: 头痛是临床最常见的神经系统疾病之一，严重影响患者的生活质量。针灸作为一种安全有效的非药物疗法，在头痛治疗领域积累了丰富的临床经验和循证医学证据。本文从现代医学头痛分类、中医辨证论治理论、临床应用研究、作用机制探索以及标准化建设等维度，系统梳理了针灸治疗头痛的最新研究进展。笔者通过检索分析近年来国内外高质量随机对照试验、系统评价及Meta分析，证实针灸在偏头痛、紧张型头痛、颈源性头痛和慢性每日头痛等常见类型的治疗中具有显著且持久的疗效，能够有效降低头痛发作频率、减轻疼痛程度并减少急性期止痛药用量。在机制方面，针灸通过调控三叉神经血管系统、神经递质释放、中枢疼痛传导通路以及局部微循环等多靶点发挥作用。本综述旨在为临床医师和研究者提供系统参考，进一步推动针灸在头痛治疗中的规范化应用和高质量发展。

Abstract: Headache is one of the most common neurological disorders in clinical practice, significantly impairing patients’ quality of life. Acupuncture, as a safe and effective non-pharmacological therapy, has accumulated extensive clinical experience and evidence-based medical data in the treatment of headaches. This article systematically reviews the latest research advancements in acupuncture for headache management from multiple perspectives, including modern medical classifications of headaches, Traditional Chinese Medicine (TCM) syndrome differentiation and treatment theories, clinical application studies, exploration of mechanisms of action, and standardization efforts. Through a systematic review of high-quality randomized controlled trials, systematic evaluations, and meta-analyses conducted domestically and internationally in recent years, the authors demonstrate that acupuncture exhibits significant and sustained therapeutic effects in treating common types of headaches such as migraine, tension-type headache, cervicogenic headache, and chronic daily headache, effectively reducing headache frequency, alleviating pain intensity, and decreasing the dosage of analgesics during acute episodes. Mechanistically, acupuncture exerts its effects through multi-target interactions involving regulation of the trigeminal nerve vascular system, neurotransmitter release, central pain transmission pathways, and local microcirculation. This review aims to provide clinicians and researchers with a comprehensive reference to further promote standardized application and high-quality development of acupuncture in headache treatment.