KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea.
Department of East-West Medical Science, Kyung Hee University, Seoul, South Korea.
Complement Ther Clin Pract. 2023 Aug;52:101763. doi: 10.1016/j.ctcp.2023.101763. Epub 2023 May 2.
Few systematic reviews have examined the effects of acupuncture on trigeminal neuralgia. This review aims to provide up-to-date evidence on the efficacy of acupuncture for managing pain in patients with trigeminal neuralgia.
Eleven databases were searched from inception until November 2022 for relevant articles Two researchers independently conducted study selection, data extraction, and evaluation. The present review solely targeted randomized controlled trials (RCTs). The Cochrane risk of bias assessment tool 2.0 was employed to assess the risk of bias. Data were compiled using RevMan 5.4.1 software, and the quality of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
Thirty studies involving 2295 patients were included in this review. Compared with carbamazepine, acupuncture led to improvements in pain scores (15 RCTs, mean difference (MD) - 1.40, 95% confidence interval (CI)-1.82 to -0.98 [95% prediction interval, -3.137,0.343], p < 0.00001, low certainty of evidence (CoE)), response rates (29 RCTs, risk ratio (RR) 1.20, 95% CI 1.15 to 1.25 [95% prediction interval, 1.067, 1.346], p < 0.00001, low CoE), frequency of pain attacks (2 RCTs, MD -2.53, 95% CI -4.11 to -0.96, P = 0.002, low CoE), and adverse effects (13 RCTs, risk difference (RD) -0.15, 95% CI -0.19 to -0.11 [95% prediction interval, -0.193, -0.108], P < 0.00001, very low CoE).
Although the quality of evidence is low, compared with carbamazepine, acupuncture may improve trigeminal neuralgia-related pain. Further rigorously designed studies are warranted to confirm the effects of acupuncture on patients with trigeminal neuralgia.
很少有系统评价研究过针灸对三叉神经痛的影响。本综述旨在提供最新的证据,评估针灸治疗三叉神经痛患者疼痛的疗效。
从建库起至 2022 年 11 月,11 个数据库被检索以获取相关文章。两位研究人员独立进行研究选择、数据提取和评估。本综述仅针对随机对照试验(RCT)。采用 Cochrane 偏倚风险评估工具 2.0 评估偏倚风险。使用 RevMan 5.4.1 软件汇总数据,并采用推荐评估、制定与评价(GRADE)方法评估证据质量。
本综述纳入了 30 项研究共 2295 名患者。与卡马西平相比,针灸可改善疼痛评分(15 项 RCT,MD-1.40,95%CI-1.82 至-0.98[95%预测区间,-3.137,0.343],p<0.00001,低质量证据(CoE))、应答率(29 项 RCT,RR 1.20,95%CI 1.15 至 1.25[95%预测区间,1.067,1.346],p<0.00001,低质量 CoE)、疼痛发作频率(2 项 RCT,MD-2.53,95%CI-4.11 至-0.96,P=0.002,低质量 CoE)和不良反应(13 项 RCT,RD-0.15,95%CI-0.19 至-0.11[95%预测区间,-0.193,-0.108],p<0.00001,极低质量 CoE)。
尽管证据质量较低,但与卡马西平相比,针灸可能改善三叉神经痛相关疼痛。需要进一步设计严谨的研究来证实针灸对三叉神经痛患者的疗效。