Acupuncture Methods for Primary Trigeminal Neuralgia: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Abstract

Background. Primary 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. Methods. Relevant 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. Results. A 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. Conclusion. These 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.

The Comparative Efficacy of Multiple Acupuncture for Alzheimer’s Disease: A Bayesian Network Meta-Analysis

“…(2) Besides, numerous investigations failed to report acupuncture details in a standardized approach in acupuncture trials. Thus, Consolidated Standards of Reporting Trials (CONSORT) [ 69 , 70 ] and STRICTA were proposed to govern the reporting. (3) Clinical heterogeneity was observed due to various factors, including acupoint selection, treatment duration, CM dose, and so on.…”

Actualización en el tratamiento de neuralgia del trigémino

“…En relación con este tema, un estudio donde se incluyeron 4126 pacientes, en donde compararon las diferentes técnicas de acupuntura, concluyendo que la acupuntura electrónica más la acupuntura manual puede ser el mejor tratamiento para la NT ya que existe una disminución en cuanto a la intensidad del dolor en un 89%, IC 95% (0,87-2,90), p=0.001, además su seguridad se respalda con la aparición de eventos adversos aceptables en el 25,86% (n=15 ECA), mientras que pacientes tratados con carbamazepina reportaron efectos adversos en un 37,93% (n=22 ECA) y ninguno de los estudios incluidos informó eventos adversos graves en relación con las técnicas de acupuntura (30) (31).…”

Uso de Estimulação Auricular Transcutânea do Nervo Vago (taVNS) e Acupuntura Escalpeana Analisado por Termografia na Neuralgia do Trigêmeo

“…Classificada como clássica ou idiopática, baseada no grau de contato neurovascular ou secundária. Entre os jovens, está relacionado à esclerose múltipla (3,4).…”

“…O tratamento farmacológico de primeira linha consiste nos anticonvulsivantes, especialmente a carbamazepina, cujos efeitos colaterais estão a reação gastrointestinal, toxicidade hepática, anemia, trombocitopenia, leucopenia, tonteira, cefaleia. A sua dose média diária é de 0,3 a 0,8 g/dia (3,6).…”

“…A duração de tratamento por acupuntura varia de 10 a 90 dias, com média de 20 a 30 dias. Há relato de acupuntura escalpeana para a neuralgia secundária do trigêmeo (1,3,4,7,8,9,10).…”