Fire Needling Plus Filiform Needling for Chronic Migraine With Comorbid Tension-Type Headache

Based on international research progress and our preliminary findings, our team proposesthat headache episodes in chronic migraine often present with clinical features oftension‐type headache. Patients commonly exhibit widespread pericranial muscletenderness. Integrating the trigemino‐cervical complex (TCC) pathway theory and thelong‐term foundation of acupuncture treatment for tension‐type headache, theinvestigators propose that chronic migraine primarily develops from the comorbidity ofmigraine and tension‐type headache, with pericranial muscle tenderness being a keypathogenic factor and therapeutic target. Fire‐needle pinpointing of tender points inpericranial muscles is a key technique for achieving favorable outcomes.This multicenter randomized controlled trial will enroll 88 patients with chronicmigraine comorbid with tension‐type headache. They will be randomly allocated in a 1:1ratio to either the experimental group or the control group via a central randomizationsystem. The experimental group will receive "fire‐needle pinpointing of pericranialtender points plus conventional filiform needle acupuncture," while the control groupwill receive "conventional filiform needle acupuncture" only. Treatment will beadministered twice weekly for 8 weeks, with a follow‐up period of 24 weeks.The study will evaluate clinical efficacy and safety by comparing the two groups in termsof headache days, pain intensity, duration, associated symptoms, emotional status,quality of life, number of pericranial tender points, and safety indicators before andafter treatment and at the end of the follow‐up period. The aim is to confirm that"pericranial muscle tender areas are the key therapeutic target for chronic migrainecomorbid with tension‐type headache" and that "fire‐needle pinpointing is the keytechnique for this target." The primary outcome will be the internationally recognizedheadache frequency. Secondary outcomes will include headache intensity, headache‐relatedemotional symptoms, and health‐related quality of life. Long‐term follow‐up will assesssustained effects, with the goal of providing an acupuncture‐based treatment strategy tosignificantly improve the clinical efficacy for chronic migraine.