METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
方法:截至2024年3月,我们在六个数据库中进行了文献检索,包括PubMed,Embase,还有Cochrane图书馆,包括英文和中文出版物。评估的主要重点包括疼痛严重程度,功能性残疾,和生活质量,在针灸治疗后至少3个月进行评估。使用Cochrane偏差风险2.0工具进行偏差风险评估,并在适用的情况下进行荟萃分析。
结果:18项随机对照试验纳入分析。针灸作为辅助治疗可以在治疗后三个月(SMD:-0.79;95%CI-1.13至-0.46;p<0.01)和六个月(MD:-18.13;95%CI-30.18至-6.07;p<0.01)提供持续的疼痛缓解。与假针灸相比,针刺在疼痛缓解方面没有统计学上的显著差异(MD:-0.12;95%CI-0.06~0.36;p=0.63).然而,如治疗后3个月的NorthwickPark颈部疼痛问卷评分(MD:-6.06;95%CI-8.20至-3.92;p<0.01)所证明的,它显著改善了功能结局。尽管9项研究报告了8.5%-13.8%的不良事件概率,这些是轻度和暂时性不良事件.
结论:对于慢性颈部疼痛患者,针灸作为辅助治疗可以提供至少3个月的治疗后疼痛缓解。虽然它不优于假针灸,在改善功能障碍方面表现出持续3个月以上的疗效,具有良好的安全性。