Wei L, Han H, Meng J, Li X, Yao QP. Meta-analysis and sequential analysis of acupuncture compared to carbamazepine in the treatment of trigeminal neuralgia. World J Clin Cases 2024; 12(22): 5083-5093 [DOI: 10.12998/wjcc.v12.i22.5083]
Corresponding Author of This Article
Li Wei, BMed, Associate Chief Physician, Department of Encephalopathy, Tianjin Beichen Traditional Chinese Medicine Hospital, No. 436 Jingjin Road, Beichen District, Tianjin 300400, China. 13642049847@163.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2024; 12(22): 5083-5093 Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.5083
Meta-analysis and sequential analysis of acupuncture compared to carbamazepine in the treatment of trigeminal neuralgia
Li Wei, Hui Han, Jie Meng, Xin Li, Qing-Ping Yao
Li Wei, Hui Han, Qing-Ping Yao, Department of Encephalopathy, Tianjin Beichen Traditional Chinese Medicine Hospital, Tianjin 300400, China
Jie Meng, Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
Xin Li, Bio-engineering Institute, Tianjin Modern Vocational Technology College, Tianjin 300350, China
Co-first authors: Li Wei and Hui Han.
Author contributions: Wei L and Han H completed the design and first draft writing of the study; Meng J and Li X collected the data; Yao QP drew the pictures; All authors reviewed the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li Wei, BMed, Associate Chief Physician, Department of Encephalopathy, Tianjin Beichen Traditional Chinese Medicine Hospital, No. 436 Jingjin Road, Beichen District, Tianjin 300400, China. 13642049847@163.com
Received: April 10, 2024 Revised: May 24, 2024 Accepted: June 11, 2024 Published online: August 6, 2024 Processing time: 82 Days and 20.4 Hours
Abstract
BACKGROUND
In this randomized controlled trial (RCT) comparing current acupuncture with carbamazepine for trigeminal neuralgia, meta- and sequential analyses were utilized.
AIM
To guide clinical decision making regarding the treatment of trigeminal neuralgia with carbamazepine.
METHODS
The RCT literature on needle comparison was searched in various Chinese biomedical databases including Chinese Biomedical Literature Database, Wanfang Data, VIP Database, as well as international databases such as Excerpt Medica Database, Cochrane Library, PubMed, and Web of Science, along with related clinical registration platforms such as World Health Organization International Clinical Trial Registry Platform, ChiCTR, and Clinical Trials up to 1 April 2020. Risk of bias was evaluated using the Cochrane Collaborative Risk Bias tool, primary outcome measures (pain reduction) were analyzed using STATA meta-analysis, outcome measures were analyzed using trial sequential analysis 0.9.5.10 Beta sequential analysis, GRADE was used to assess the evidence, and adverse reactions were documented.
RESULTS
This study analyzed 16 RCTs with a total of 1231 participants. The meta-analysis revealed a statistically significant difference in pain reduction between acupuncture and carbamazepine [standardized mean difference (SMD) = 1.47; 95% confidence interval (CI): 0.99-1.95], although the quality of evidence was deemed to be of extremely low quality. Cumulative meta-analysis based on the year of publication indicated that carbamazepine treatment first demonstrated a statistically significant difference in pain reduction in 2014 and remained relatively stable over time [SMD = 1.84; 95%CI: 0.22-3.47]. Additionally, the number of adverse events associated with acupuncture was significantly lower compared to carbamazepine.
CONCLUSION
Acupuncture for trigeminal neuralgia is better than analgesia and safer than carbamazepine; however, firm conclusions still require a high-quality, multicenter, large-sample RCT to confirm these findings.
Core Tip: Randomized controlled trial studies have confirmed that both acupuncture and carbamazepine have significant therapeutic effects on primary trigeminal neuralgia. Our meta-analysis results showed that acupuncture treatment for trigeminal neuralgia is superior to analgesics and safer than carbamazepine.
