Wong Lit Wan D, Wang Y, Xue C C L, Wang L P, Liang F R, Zheng Z
School of Health Sciences, and Health Innovations Research Institute, RMIT University, Bundoora, Vic., Australia.
Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, Affiliated to Capital Medical University, Beijing, China.
Eur J Pain. 2015 Oct;19(9):1232-47. doi: 10.1002/ejp.671. Epub 2015 Feb 17.
One in four people suffers from chronic musculoskeletal pain (CMP). Acupuncture points stimulation is increasingly used for pain relief for CMP. Commonly, a combination of local and distant points is used. However, the difference between the effects of local and distant point stimulation is unknown. This systematic review aimed to determine if there was a difference in effects between stimulating local and distant points, and the combination of both when compared with either alone. English and Chinese electronic databases were searched to identify randomized controlled trials, where local or distant points were stimulated in adults with CMP. Pain intensity was the primary outcome measure. Nineteen were included in the qualitative analysis and 15 in the meta-analysis. Local and distant point stimulation was more effective than their respective controls in pain reduction immediately after treatment. Three studies directly compared the stimulation of local and distant points and found no significant difference between the two. No studies compared combined local and distant point stimulation with either alone. Subgroup analyses showed that, local tender point stimulation was more effective than local acupuncture points. Local and distant point stimulation induces similar degree of acupuncture analgesia. The benefit of combining local and distant point stimulation is unknown. However, subgroup analyses suggested that local tender points could be important in the treatment of CMP for short-term pain relief.
四分之一的人患有慢性肌肉骨骼疼痛（CMP）。穴位刺激越来越多地用于缓解CMP的疼痛。通常，会使用局部穴位和远端穴位相结合的方法。然而，局部穴位刺激和远端穴位刺激的效果差异尚不清楚。本系统评价旨在确定刺激局部穴位和远端穴位以及两者结合与单独刺激相比在效果上是否存在差异。检索了英文和中文电子数据库，以识别在患有CMP的成年人中刺激局部或远端穴位的随机对照试验。疼痛强度是主要结局指标。19项研究纳入了定性分析，15项纳入了荟萃分析。治疗后即刻，局部穴位和远端穴位刺激在减轻疼痛方面比各自的对照更有效。三项研究直接比较了局部穴位和远端穴位的刺激，发现两者之间没有显著差异。没有研究将局部和远端穴位联合刺激与单独刺激进行比较。亚组分析表明，局部压痛点刺激比局部穴位针刺更有效。局部穴位和远端穴位刺激诱导的针刺镇痛程度相似。局部和远端穴位联合刺激的益处尚不清楚。然而，亚组分析表明，局部压痛点在CMP的短期疼痛缓解治疗中可能很重要。
