Evidence-Based Research Of Manual Acupuncture For Myofascial Pain Syndrome

Objectives Analyse the current situation of research on the analgesia by manual acupuncture;compare the effect and safety of manual acupuncture versus local lidocaine injection to the myofascial pain syndrome;compare the effectiveness and safety of needling local acupoints only and distal acupoin combine local acupuncture points to MPS,effectively guide clinical practice.Methods(1)Bibliometrics methods: Analyze the characteristics of relevant literatures about manual acupuncture analgesia through the BICOMS2 software,gCLUTO software,Ucinet6.0 software and Netdraw software.(2)systematic review: Conduct the randomized controlled trials contained manual acupuncture versus injection therapy for MPS,evaluate the methodological quality,use the Review Manager 5.3 to make a meta-analysis of the outcome indicator.(3)Observational CER: The prospective cohort study was used to design the experimental process and calculate the sample size.Pain intensity of VAS score,The health condition and health index of EQ-5D-3L were observed,And the results were collected before treatment,after first course and after total treatment in 66 patients with MPS met the inclusion criteria.SPSS software was used to analyze the outcome indexes,the statistical level of significance was set at P?0.05.Results(1)The current research status of manual acupuncture analgesia:At present,there are 1320 kinds of English journals published in the literature of manual acupuncture analgesia while there are 1039 Chinese journals,and there are 48 countries in the world with such studys.The Chinese and English study authors reach a wide range,forming three major social network groups respectivly.The highest word frequency of keywords in English are acupuncture therapy ?acupuncture points?acupuncture analgesia while in chinese are acupuncture,lumbar disc herniation,migraine,at the same time,they located at the center of the social network.(2)The results of system review: A total of 12 randomized controlled trials of MPS treated with manual acupuncture versus injection therapy were conducted,and the heterogeneity was greater in each study.There was no significant statistical difference of VAS scores,PPT and ROM between manual acupuncture and wet needle after the overall course.It was found that the effect tends to be better of local lidocaine injection after 1 course of treatment [SMD=-0.45,95%CI(-0.71,-0.12)].The effect seems to be better of manual acupuncture after 2 course [SMD=0.67,95%CI(0.15,1.19)].When subgroup analysis was performed on the times of treatments,it was found the manual acupuncture was more effective than local injection at 8 times [SMD=0.79,95%CI(0.23,1.36)].When subgroup analysis was performed in the acupoint,the effect seems to be better of local lidocaine injection when acupuncture MTrPs [SMD=-0.41,95%CI(-0.62,-0.21)].In terms of adverse reactions,the incidence of pain and discomfort in the treatment of MPS with manual acupuncture was higher than that in the local injection group,the comparison between the two groups was statistically significant.(3)Clinical observational study: it was found that the analgesic effect(VAS score)of the local combined distal acupoint hand twist needle for MPS was better than the local only,The comparison was statistically significant[P=0.009],There was no significant difference between the eq-5d VAS score and the eq-5d-3l health index in the two groups.But the VAS scores(P=0.000),the eq-5d VAS health scores(P=0.000)and the eq-5d-3l health index(P=0.000)of the two groups were statistically significant in different treatment course,no adverse reactions occurred during the test.Conclusions The literature number of manual acupuncture analgesia was steadily increasing year by year,the research focuses on the therapeutic effect of various chronic pain,stroke and its sequelae and neuropathic pain.At the same time,it can be found that the relevant data standardization of the analgesia by manual acupuncture in the current research is more and more important.It was found that there is no statistical significance between manual acupuncture and local lidocaine injection on pain relief for myofascial pain syndrome through the system review,but the local lidocaine injection effect tend to be better in immediate and short-term,and manual acupuncture effect tend to be better in medium-term.The adverse reaction of manual acupuncture was mainly pain and prickly discomfort,the adverse reaction of lidocaine injection was more and the safety risk was greater.It was found that the analgesic effect of local combined distal acupoint was better than that of the local acupoint group.Both the patients' health status and the quality of life were improved to varying degrees.