Abstract：
BACKGROUND: Tension-type headache (TTH) is common but challenging to manage due to limited effectiveness of conventional treatments. This study examines six complementary and alternative medicine (CAM) interventions through network meta-analysis to identify effective TTH management strategies.
METHODS: We searched PubMed, Embase, Web of Science, Cochrane Library, OVID, CNKI, Wanfang, VIP, and CBM databases for randomized controlled trials on CAM for TTH treatment. Headache frequency and intensity were the primary outcomes. Methodological quality was evaluated on the basis of the Cochrane risk of bias tool. We used R software to conduct this Bayesian network meta-analysis. We used mean difference (MD) with 95% credible intervals (CI) to calculate the continuous outcomes and analyzed the percentages of the surface under the cumulative ranking (SUCRA) curve.
RESULTS: In total, 32 randomized controlled trials (RCTs) with 2405 participants were analyzed. For reducing headache intensity, the network meta-analysis shows that acupuncture therapy combined with traditional Chinese medicine (AT_TCM), manual therapy (MT), psychological treatment (PT), and traditional Chinese medicine combined with acupuncture and manual therapy (TCM_AT_MT) are superior to Western medicine (WM). In the SUCRA curve, TCM_AT_MT is the best for reducing headache frequency (HF).
CONCLUSIONS: This review, assessed as low-quality evidence by GRADE, cautiously suggests potential benefits of PT over other CAM interventions for TTH and indicates TCM_AT_MT might better reduce HF. It proposes that combining CAM interventions could enhance outcomes. Due to the preliminary nature of these findings, further high-quality RCTs are essential to confirm these suggestions and provide clearer clinical guidance.
UNASSIGNED: CRD42021252073.
METHODS: We searched PubMed, Embase, Web of Science, Cochrane Library, OVID, CNKI, Wanfang, VIP, and CBM databases for randomized controlled trials on CAM for TTH treatment. Headache frequency and intensity were the primary outcomes. Methodological quality was evaluated on the basis of the Cochrane risk of bias tool. We used R software to conduct this Bayesian network meta-analysis. We used mean difference (MD) with 95% credible intervals (CI) to calculate the continuous outcomes and analyzed the percentages of the surface under the cumulative ranking (SUCRA) curve.
RESULTS: In total, 32 randomized controlled trials (RCTs) with 2405 participants were analyzed. For reducing headache intensity, the network meta-analysis shows that acupuncture therapy combined with traditional Chinese medicine (AT_TCM), manual therapy (MT), psychological treatment (PT), and traditional Chinese medicine combined with acupuncture and manual therapy (TCM_AT_MT) are superior to Western medicine (WM). In the SUCRA curve, TCM_AT_MT is the best for reducing headache frequency (HF).
CONCLUSIONS: This review, assessed as low-quality evidence by GRADE, cautiously suggests potential benefits of PT over other CAM interventions for TTH and indicates TCM_AT_MT might better reduce HF. It proposes that combining CAM interventions could enhance outcomes. Due to the preliminary nature of these findings, further high-quality RCTs are essential to confirm these suggestions and provide clearer clinical guidance.
UNASSIGNED: CRD42021252073.
摘要：
背景：紧张型头痛（TTH）很常见，但由于常规治疗的有效性有限，因此难以控制。本研究通过网络荟萃分析研究了六种补充和替代医学（CAM）干预措施，以确定有效的TTH管理策略。
方法：我们搜索了PubMed，Embase,WebofScience,科克伦图书馆,OVID,CNKI,万方,VIP,和CBM数据库用于TTH治疗的CAM随机对照试验。头痛频率和强度是主要结果。基于Cochrane偏倚风险工具评估方法学质量。我们使用R软件进行了贝叶斯网络荟萃分析。我们使用具有95％可信间隔（CI）的平均差（MD）来计算连续结果，并分析了累积排名（SUCRA）曲线下的表面百分比。
结果：总计，对32项随机对照试验(RCTs)进行分析，纳入2405名参与者。为了减轻头痛强度，网络荟萃分析表明,针灸疗法结合中药(AT_TCM),手动治疗（MT），心理治疗（PT），中医结合针灸和手法治疗（TCM_AT_MT）优于西医（WM）。在SUCRA曲线中,TCM_AT_MT是减少头痛频率（HF）的最佳选择。
结论：这篇综述，按等级评估为低质量证据，谨慎地建议PT相对于其他CAM干预TTH的潜在益处，并表明TCM_AT_MT可能更好地降低HF。它建议将CAM干预措施结合起来可以增强结果。由于这些发现的初步性质，进一步的高质量RCT对于证实这些建议和提供更清晰的临床指导至关重要.
■CRD42021252073。
方法：我们搜索了PubMed，Embase,WebofScience,科克伦图书馆,OVID,CNKI,万方,VIP,和CBM数据库用于TTH治疗的CAM随机对照试验。头痛频率和强度是主要结果。基于Cochrane偏倚风险工具评估方法学质量。我们使用R软件进行了贝叶斯网络荟萃分析。我们使用具有95％可信间隔（CI）的平均差（MD）来计算连续结果，并分析了累积排名（SUCRA）曲线下的表面百分比。
结果：总计，对32项随机对照试验(RCTs)进行分析，纳入2405名参与者。为了减轻头痛强度，网络荟萃分析表明,针灸疗法结合中药(AT_TCM),手动治疗（MT），心理治疗（PT），中医结合针灸和手法治疗（TCM_AT_MT）优于西医（WM）。在SUCRA曲线中,TCM_AT_MT是减少头痛频率（HF）的最佳选择。
结论：这篇综述，按等级评估为低质量证据，谨慎地建议PT相对于其他CAM干预TTH的潜在益处，并表明TCM_AT_MT可能更好地降低HF。它建议将CAM干预措施结合起来可以增强结果。由于这些发现的初步性质，进一步的高质量RCT对于证实这些建议和提供更清晰的临床指导至关重要.
■CRD42021252073。
