Acupuncture for primary trigeminal neuralgia: A systematic review and PRISMA-compliant meta-analysis

Hu, Hantong; Chen, Lifang; Ma, Ruijie; Gao, Hong; Fang, Jianqiao

doi:10.1016/j.ctcp.2018.12.013

Cited by 31 publications

(37 citation statements)

References 11 publications

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“…The body of evidence regarding the use of acupuncture in pain management has been growing in recent years, especially as an adjunct in labor analgesia [18,19] rheumatologic and orthopedic diseases [20][21][22]. However, the studies on the use of acupuncture for patients with trigeminal neuralgia have failed to draw a robust conclusion regarding the efficacy of acupuncture, as reflected by a recent systematic review and meta-analysis [9]. The studies included in the meta-analysis were limited by their short follow up periods, lack of standardization of acupuncture points and acupuncture manipulation techniques (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Trigeminal neuralgia (TN) is a debilitating disease characterized by episodic, unilateral, electric shock-like neuropathic facial pain that is touch-evoked in one or more divisions of the trigeminal nerve [1][2][3]. It has significant impact on the quality of life and the socioeconomic functioning of the patients [4][5][6][7][8][9]. Although it is well known that trigeminal neuralgia is associated with vascular compression of the trigeminal nerve root and that demyelination of trigeminal nerve is the predominant disease mechanism, the exact pathophysiology and etiological factors of the disease remain speculative [1,3,7].…”

Section: Introductionmentioning

confidence: 99%

“…Many surgical techniques have been used, including micro vascular decompression, gamma knife surgery, radiofrequency thermo coagulation, partial sensory rhizotomy, balloon decompression, and glycerol rhizolysis, but also have only low quality evidence and low to moderate efficacy [8]. Despite recent advances in therapeutics, the efficacy of mainstream medical therapies remains unsatisfactory, due to drug intolerance, decrease of therapeutic effect over time and high incidence of symptom recurrence [9,10]. Acupuncture, a complementary medicine modality, has been demonstrated to have analgesic effects with low rates of complications.…”

Section: Introductionmentioning

confidence: 99%

“…A randomized controlled trial showed that trigeminal neuralgia patients who received acupuncture intervention in addition to carbamazepine, compared to the control group which received carbamazepine alone, have improved cognitive function and quality of life [14]. In a recent systematic review and metaanalysis, acupuncture alone compared with carbamazepine alone showed superior clinical efficacy in terms of response rate, pain score, as well as recurrence rate while acupuncture combined with carbamazepine in contrast to carbamazepine alone demonstrated a better response rate [9]. However, the included studies were all from mainland China and the overall quality of evidence as measured using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was deemed to be "low" or "very low" [16].…”

Section: Introductionmentioning

confidence: 99%

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The Influence of Magnetic Resonance Imaging and Adjunct Acupuncture on LongTerm Pain Improvement for Patients with Trigeminal Neuralgia

2020

JAPM

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Trigeminal neuralgia is a debilitating disease characterized by neuropathic facial pain which significantly impact on the patient’s quality of life and socioeconomic function. For patients with trigeminal neuralgia, Magnetic Resonance Imaging (MRI) is a routine investigation recommended in recent clinical guidelines but it remains unclear whether its use has any impact on patient-reported clinical outcomes. Acupuncture as an adjunct therapy has been shown to provide short term pain relief but its longer-term benefits remain unknown. The aims of the study are to examine whether the use of MRI and/ or adjunct acupuncture is associated with the long-term pain improvement for trigeminal neuralgia patients, and thus to inform on prognosis of trigeminal neuralgia. Methods: In this retrospective cohort study using data from routine clinical practice, we included all adult patients diagnosed with trigeminal neuralgia and managed at the Pain Management Centre, Singapore General Hospital between 2011 and 2017. Patients who have incomplete clinical data or lost to follow up are excluded. Logistic regression model was used to examine the association between the uses of MRI or adjunct MRI and pain symptom improvement at 6-12 months follow up. Results: Fifty-three patients were identified and included in this study. Neither the use of MRI nor acupuncture was found to be significantly associated with pain improvement for patients with trigeminal neuralgia at 6 to 12 months follow up after the initial diagnosis. Conclusion: The use of MRI or adjunct acupuncture did not seem to be related to long-term pain improvement for patients with trigeminal neuralgia and thus has limited prognostic value. These findings would have to be confirmed by further studies of larger sample size, and ideally with prospective randomized clinical trials.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Influence of Magnetic Resonance Imaging and Adjunct Acupuncture on LongTerm Pain Improvement for Patients with Trigeminal Neuralgia

2020

JAPM

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“…It is usually unilateral, severe, transient, and recurrent, causing great pain to patients. As the disease progresses, patients may have difficulty eating, talking and maintaining facial hygiene in fear of triggering the pain, which has a profound impact on the quality of life ( 1 , 3 , 4 ). Neuropathic pain is common in trigeminal neuralgia, peripheral neuropathy, and multiple sclerosis ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of MVD combined with PSR in the treatment of primary trigeminal neuralgia

et al. 2020

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Clinical efficacy of microvascular decompression (MVD) combined with percutaneous stereotactic radiofrequency rhizotomy (PSR) in the treatment of primary trigeminal neuralgia was investigated. The medical records of 141 patients with primary trigeminal neuralgia admitted to Shandong Provincial Hospital from May 2011 to June 2013 were collected. Among them, 63 patients received MVD surgery and were set as group A, while the other 78 received MVD combined with PSR and were as group B. The efficacy and complication of the two treatment methods were compared. Multivariate logistic regression was performed to analyze the risk factors for treatment efficacy. The total effective rate was 96.15% in group B, higher than that in group A (88.89%), but the difference was not statistically significant (P>0.05). The complications in group B were statistically less than that in group A (P<0.05). Risk factors for the onset of primary trigeminal neuralgia included the degree of decompression, duration of disease, degree of compression, and clinical symptoms. Patients treated with MVD combined with PSR had a better quality of life and lower 5-year recurrence rate than patients treated with MVD (both P<0.05). In conclusion, MVD combined with PSR treatment has good clinical efficacy in primary trigeminal neuralgia and low incidence of complications. The possible risk factors for the onset of primary trigeminal neuralgia include the degree of decompression, duration of disease, degree of compression, and clinical symptoms.

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Use of Acupuncture for Adult Health Conditions, 2013 to 2021

et al. 2022

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ImportanceAcupuncture is a popular treatment that has been advocated for dozens of adult health conditions and has a vast evidence base.ObjectiveTo map the systematic reviews, conclusions, and certainty or quality of evidence for outcomes of acupuncture as a treatment for adult health conditions.Evidence ReviewComputerized search of PubMed and 4 other databases from 2013 to 2021. Systematic reviews of acupuncture (whole body, auricular, or electroacupuncture) for adult health conditions that formally rated the certainty, quality, or strength of evidence for conclusions. Studies of acupressure, fire acupuncture, laser acupuncture, or traditional Chinese medicine without mention of acupuncture were excluded. Health condition, number of included studies, type of acupuncture, type of comparison group, conclusions, and certainty or quality of evidence. Reviews with at least 1 conclusion rated as high-certainty evidence, reviews with at least 1 conclusion rated as moderate-certainty evidence, and reviews with all conclusions rated as low- or very low-certainty evidence; full list of all conclusions and certainty of evidence.FindingsA total of 434 systematic reviews of acupuncture for adult health conditions were found; of these, 127 reviews used a formal method to rate certainty or quality of evidence of their conclusions, and 82 reviews were mapped, covering 56 health conditions. Across these, there were 4 conclusions that were rated as high-certainty evidence, and 31 conclusions that were rated as moderate-certainty evidence. All remaining conclusions (&gt;60) were rated as low- or very low-certainty evidence. Approximately 10% of conclusions rated as high or moderate-certainty were that acupuncture was no better than the comparator treatment, and approximately 75% of high- or moderate-certainty evidence conclusions were about acupuncture compared with a sham or no treatment.Conclusions and RelevanceDespite a vast number of randomized trials, systematic reviews of acupuncture for adult health conditions have rated only a minority of conclusions as high- or moderate-certainty evidence, and most of these were about comparisons with sham treatment or had conclusions of no benefit of acupuncture. Conclusions with moderate or high-certainty evidence that acupuncture is superior to other active therapies were rare.

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Acupuncture for primary trigeminal neuralgia: A systematic review and PRISMA-compliant meta-analysis

Cited by 31 publications

References 11 publications

The Influence of Magnetic Resonance Imaging and Adjunct Acupuncture on LongTerm Pain Improvement for Patients with Trigeminal Neuralgia

The Influence of Magnetic Resonance Imaging and Adjunct Acupuncture on LongTerm Pain Improvement for Patients with Trigeminal Neuralgia

Clinical efficacy of MVD combined with PSR in the treatment of primary trigeminal neuralgia

Use of Acupuncture for Adult Health Conditions, 2013 to 2021

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