Meta-analysis and sequential analysis of acupuncture compared to carbamazepine in the treatment of trigeminal neuralgia

Table 1 Basic features included in the literature

Ref.	Sample	Literature type	Random ratio	Intervention measures		Main outcome measures	Needle retention time	Treatment frequency	Course of treatment	Main conclusion
Chen and He[38] (2021)	90	RCT	1:1	Treatment group	Control group	VAS	30 min	Once a day	4 wk	+
Chi et al[39] (2021)	88	RCT	1:1	Acupuncture	Carbamazepine	VAS/adverse event	20 min	Once a day	1 mo	+
Niu[40] (2021)	63	RCT	1:1	Acupuncture	Carbamazepine	VAS/adverse event	30 min	Once a day	30 d	+
Qin[41] (2021)	62	RCT	1:1	Acupuncture	Carbamazepine	VAS	20 min	Once a day	1 mo	+
Wang and Zeng[42] (2021)	100	RCT	1:1	Acupuncture	Carbamazepine	VAS	30 min	Once a day	30 d	+
Wang[43] (2020)	60	RCT	1:1	Acupuncture	Carbamazepine	VAS	20 min	Once a day	3 mo	+
Ta[44] (2020)	82	RCT	1:1	Acupuncture	Carbamazepine	VAS	30 min	Once a day	30 wk	+
Zhang et al[45] (2019)	62	RCT	1:1	Acupuncture	Carbamazepine	VAS	30 min	Once a day	90 d	+
Hao et al[46] (2019)	80	RCT	1:1	Acupuncture	Carbamazepine	VAS/adverse event	-	Once a day	-	+
Wu et al[47] (2019)	100	RCT	1:1	Acupuncture	Carbamazepine	VAS/adverse event	40 min	Once a day	4 wk	+
Xu and Wang[48] (2019)	84	RCT	1:1	Acupuncture	Carbamazepine	VAS/adverse event	20 min	Once a day	4 wk	+
Mu[49] (2019)	80	RCT	1:1	Acupuncture	Carbamazepine	VAS	20 min	Once a day	30 d	+
Wu and Sun[50] (2019)	60	RCT	1:1	Acupuncture	Carbamazepine	VAS	30 min	Once a day	4 wk	+
Liu and Liu[51] (2019)	40	RCT	1:1	Acupuncture	Carbamazepine	VAS	30 min	Once a day	30 d	+
Wang[52] (2019)	60	RCT	1:1	Acupuncture	Carbamazepine	VAS	30 min	Once a day	30 d	-
Si[53] (2018)	120	RCT	1:1	Acupuncture	Carbamazepine	VAS	30 min	Once a day	30 d	+

RCT: Randomized controlled trial; VAS: Visual analog scale.

Table 2 Grading of Recommendations Assessment, Development and Evaluation quality grading for acupuncture treatment of trigeminal neuralgia

Intervention measures	RCT (number of patients)	Effect size (95%CI)	Factors for evaluating evidence quality					Evidence quality
			Limitations	Inconsistency	Indirectness	Imprecision	Publication bias
Acupuncture vs carbamazepine	16 (1231)	SMD 1.47 (0.99 to 1.95)	-11	-12	0	0	-13	Extremely low

¹Most of the information comes from moderate bias risk randomized controlled trial;

²P value of heterogeneity test is small, the I² value is large, and there is less overlap in the size, direction, and confidence interval of the effect magnitude;

³Egger’s test suggests a significant publication bias. RCT: Randomized controlled trial; SMD: Standardized mean difference.

Table 3 Adverse event reports of acupuncture

Ref.	Treatment group as A	Control group as B	Sample size as A/B	Adverse event
Si[53]	Acupuncture	Carbamazepine	44/44	A: 1 case
				B: 6 cases
Wu and Sun[50]	Acupuncture	Carbamazepine	32/31	A: 1 case of pigmentation
				B: 5 cases of dizziness and 1 case of exfoliative dermatitis
Hao et al[46]	Acupuncture	Carbamazepine	40/40	A: 2 cases of pigmentation
				B: 6 cases of dizziness and 1 case of exfoliative dermatitis
Zhang et al[45]	Acupuncture	Carbamazepine	50/50	A: 1 case of dizziness caused by acupuncture
				B: Mild digestive system adverse reactions, 4 cases with mild liver dysfunction, and 2 cases with rash
Wang[52]	Acupuncture	Carbamazepine	42/42	A: 3 cases of drowsiness
				B: 3 cases of dizziness, 5 cases of drowsiness, and 3 cases of vomiting