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The effects of acupuncture on occipital neuralgia: a systematic review and meta-analysis.

ABSTRACT: BACKGROUND:Occipital neuralgia is one of the main causes of occipital pain. This systematic review aims to assess the level of evidence in randomized controlled trials (RCTs) on the effects of acupuncture on occipital neuralgia. METHODS:We searched 11 databases and a journal archive from their inception up to December 2019 for relevant RCTs. We did not place any specific restrictions on patients diagnosed with occipital neuralgia, such as age or gender. We included studies that used an acupuncture intervention group, with or without the control group treatment, and that set a control group receiving active, interventional treatment such as medication. For outcomes, we used visual analogue scale (VAS) and effective rate. RESULTS:We included a total of 11 RCTs. All VAS scores (mean difference [MD] -2.35, 95% confidence interval [CI] -2.84, -?1.86) and effective rate values (odds ratio [OR] 4.96, 95% CI 2.24, 10.96) showed significant differences in effect between acupuncture treatment alone and the control group treatment. Similarly, combined acupuncture treatment with control group treatment also showed significant effects in effective rate (OR 6.68, 95% CI 1.11, 40.37). We performed a subgroup analysis on studies that used acupuncture only as the intervention and reported the effective rate, and found that all acupuncture subgroups showed significant effects compared to the control group treatments. None of the studies reported severe adverse effects. CONCLUSIONS:Although acupuncture only and combined acupuncture treatments showed significant effects compared to medication, the results of this study are inconclusive. Studies with rigorous study design and larger sample sizes are needed to confirm the role of acupuncture in this field. TRIAL REGISTRATION:International prospective register for systematic review (PROSPERO) number CRD42019128050.

SUBMITTER: Yun JM

PROVIDER: S-EPMC7268636 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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The effects of acupuncture on occipital neuralgia: a systematic review and meta-analysis.

Yun Jung-Min JM Lee Sook-Hyun SH Cho Jae-Heung JH Kim Koh-Woon KW Ha In-Hyuk IH

BMC complementary medicine and therapies 20200603 1

<h4>Background</h4>Occipital neuralgia is one of the main causes of occipital pain. This systematic review aims to assess the level of evidence in randomized controlled trials (RCTs) on the effects of acupuncture on occipital neuralgia.<h4>Methods</h4>We searched 11 databases and a journal archive from their inception up to December 2019 for relevant RCTs. We did not place any specific restrictions on patients diagnosed with occipital neuralgia, such as age or gender. We included studies that us ...[more]

PMID: 32493452

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Project description:BackgroundAcupuncture is used to treat subjects with occipital neuralgia, which is 1 of the main causes of occipital pain; however, its effect is conflicting. Hence, the current study aims to evaluate the effects of acupuncture in the treatment of occipital neuralgia.MethodsIn a systematic search of PubMed, Embase, OVID, China National Knowledge Infrastructure, Cochrane Library, Chinese Biomedical Literature Database, Wanfang databases, and Google Scholar until July 2021, 15 studies aimed to evaluate the effects of acupuncture in the treatment of occipital neuralgia were included. Human-related trials were considered in different languages. The size of the study was not considered a limit for its inclusion and the study intervention should focus on comparing the impact of acupuncture in the intervention group compared with the control group.The odds ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were calculated with a random or fixed-effect model for different subgroup analyses. Publication bias was assessed using the Egger test, while the risk of bias was assessed using the Review manager software.ResultsAcupuncture had a significantly higher effective rate of treatment (OR, 5.40; 95% CI, 2.48 to 11.77, P < .001) compared to control in the treatment of occipital neuralgia and lower visual analogue scale (MD, -2.45; 95% CI, -2.69 to -2.21, P < .001). Acupuncture plus medication had a significantly higher effective rate of treatment (OR, 3.96; 95% CI, 2.10 to 7.47, P < .001) compared to medication in the treatment of occipital neuralgia. Acupuncture analysis for safety issues showed a significant reduction of adverse events compared with the medication group.ConclusionAcupuncture alone or acupuncture plus medication had a significantly beneficial effect on the effective rate of treatment, safety and visual analog scale compared to medication in the treatment of occipital neuralgia. Further studies are required to validate these findings.

Project description:BackgroundPrimary trigeminal neuralgia (PTN) is a clinical refractory disorder characterized by excruciating pain that severely impacts the quality of life. Several studies have shown that acupuncture can improve PTN pain. However, the comparative efficacy and safety of acupuncture are unknown. Herein, a systematic review was conducted to compare the efficacy and safety of various acupuncture methods for PTN treatment.MethodsRelevant randomized controlled trials (RCTs) published up to 1 August 2021 were obtained from PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, CQVIP Database, Wanfang Database, Allied and Alternative Medicine Database, and related registration platforms. Two authors independently selected the studies and obtained data. Cochrane Handbook was used to assess the methodological quality. We put the pain relief as the primary outcome and the response rate and adverse events as the secondary outcomes. Review Manager v5.3, ADDIS v1.16.8, and STATA v15.0 software were used for data analysis. The intraclass correlation coefficient was used to assess the consistency of the two investigators.ResultsA total of 58 RCTs with 4,126 participants were obtained. The meta-analysis indicated that five acupuncture methods were superior to conventional medicine (carbamazepine) in pain reduction intensity and response rate. Meanwhile, electronic acupuncture plus manual acupuncture was the most effective therapy since it reduced pain intensity in 11 methods and improved the response rate in 10 interventions. Moreover, six interventions had acceptable adverse events, and none of the included studies reported severe adverse events. However, most pieces of evidence were ranked as critically low.ConclusionThese findings show that acupuncture methods can be effective and safe for PTN. Moreover, electronic acupuncture plus manual acupuncture maybe the best acupuncture treatment for PTN and should be administered to PTN patients. However, additional well-designed and high-quality RCTs should be conducted to verify the above findings in the future. The systematic review is registered with CRD42020221456.

Project description:BackgroundThe effect of acupuncture on sensory perception has never been systematically reviewed; although, studies on acupuncture mechanisms are frequently based on the idea that changes in sensory thresholds reflect its effect on the nervous system.MethodsPubmed, EMBASE and Scopus were screened for studies investigating the effect of acupuncture on thermal or mechanical detection or pain thresholds in humans published in English or German. A meta-analysis of high quality studies was performed.ResultsOut of 3007 identified articles 85 were included. Sixty five studies showed that acupuncture affects at least one sensory threshold. Most studies assessed the pressure pain threshold of which 80% reported an increase after acupuncture. Significant short- and long-term effects on the pressure pain threshold in pain patients were revealed by two meta-analyses including four and two high quality studies, respectively. In over 60% of studies, acupuncture reduced sensitivity to noxious thermal stimuli, but measuring methods might influence results. Few but consistent data indicate that acupuncture reduces pin-prick like pain but not mechanical detection. Results on thermal detection are heterogeneous. Sensory threshold changes were equally frequent reported after manual acupuncture as after electroacupuncture. Among 48 sham-controlled studies, 25 showed stronger effects on sensory thresholds through verum than through sham acupuncture, but in 9 studies significant threshold changes were also observed after sham acupuncture. Overall, there is a lack of high quality acupuncture studies applying comprehensive assessments of sensory perception.ConclusionsOur findings indicate that acupuncture affects sensory perception. Results are most compelling for the pressure pain threshold, especially in pain conditions associated with tenderness. Sham acupuncture can also cause such effects. Future studies should incorporate comprehensive, standardized assessments of sensory profiles in order to fully characterize its effect on sensory perception and to explore the predictive value of sensory profiles for the effectiveness of acupuncture.

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The effects of acupuncture on occipital neuralgia: a systematic review and meta-analysis.

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The effects of acupuncture on occipital neuralgia: a systematic review and meta-analysis.

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