Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No.5 Beixiange St, Xicheng District, Beijing, 100053, China.
Graduate College, Beijing University of Chinese Medicine, Beijing, China.
Curr Pain Headache Rep. 2024 Sep;28(9):957-969. doi: 10.1007/s11916-024-01267-x. Epub 2024 Jun 10.
Chronic neck pain, a prevalent health concern characterized by frequent recurrence, requires exploration of treatment modalities that provide sustained relief. This systematic review and meta-analysis aimed to evaluate the durable effects of acupuncture on chronic neck pain.
We conducted a literature search up to March 2024 in six databases, including PubMed, Embase, and the Cochrane Library, encompassing both English and Chinese language publications. The main focus of evaluation included pain severity, functional disability, and quality of life, assessed at least 3 months post-acupuncture treatment. The risk of bias assessment was conducted using the Cochrane Risk of Bias 2.0 tool, and meta-analyses were performed where applicable.
Eighteen randomized controlled trials were included in the analysis. Acupuncture as an adjunct therapy could provide sustained pain relief at three (SMD: - 0.79; 95% CI - 1.13 to - 0.46; p < 0.01) and six (MD: - 18.13; 95% CI - 30.18 to - 6.07; p < 0.01) months post-treatment. Compared to sham acupuncture, acupuncture did not show a statistically significant difference in pain alleviation (MD: - 0.12; 95% CI - 0.06 to 0.36; p = 0.63). However, it significantly improved functional outcomes as evidenced by Northwick Park Neck Pain Questionnaire scores 3 months post-treatment (MD: - 6.06; 95% CI - 8.20 to - 3.92; p < 0.01). Although nine studies reported an 8.5%-13.8% probability of adverse events, these were mild and transitory adverse events.
Acupuncture as an adjunct therapy may provide post-treatment pain relief lasting at least 3 months for patients with chronic neck pain, although it is not superior to sham acupuncture, shows sustained efficacy in improving functional impairment for over 3 months, with a good safety profile.
慢性颈痛是一种常见的健康问题，其特点是频繁复发，需要探索提供持续缓解的治疗方法。本系统评价和荟萃分析旨在评估针灸治疗慢性颈痛的持久效果。
我们对截至 2024 年 3 月的六个数据库（包括 PubMed、Embase 和 Cochrane 图书馆）进行了文献检索，包括英语和中文出版物。评估的主要重点包括针灸治疗后至少 3 个月时的疼痛严重程度、功能障碍和生活质量。使用 Cochrane 偏倚风险 2.0 工具进行偏倚风险评估，并在适用的情况下进行荟萃分析。
纳入的 18 项随机对照试验进行了分析。针灸作为辅助治疗可在治疗后 3 个月（SMD：-0.79；95%CI：-1.13 至-0.46；p<0.01）和 6 个月（MD：-18.13；95%CI：-30.18 至-6.07；p<0.01）时提供持续的疼痛缓解。与假针灸相比，针灸在缓解疼痛方面没有统计学上的显著差异（MD：-0.12；95%CI：-0.06 至 0.36；p=0.63）。然而，它显著改善了功能结果，表现为治疗后 3 个月时 Northwick Park 颈痛问卷评分的降低（MD：-6.06；95%CI：-8.20 至-3.92；p<0.01）。尽管 9 项研究报告了 8.5%-13.8%的不良事件概率，但这些都是轻度和短暂的不良事件。
针灸作为辅助治疗可能为慢性颈痛患者提供至少 3 个月的治疗后疼痛缓解，尽管它并不优于假针灸，但在改善功能障碍方面持续有效超过 3 个月，具有良好的安全性。
