| Objective:1.An overview of systematic reviews of acupuncture in the treatment of chronic neck pain(CNP)is proposed to provide reference for improving the clinical treatment of chronic neck pain by acupuncture and moxibustion,and the quality of clinical trials and Systematic Review(SR),which evaluates the systematic evaluation of SR methodology,report quality and outcome index quality of acupuncture in the treatment of chronic neck pain.2.In order to provide evidence for the scientific treatment of chronic neck pain,the clinical efficacy of electroacupuncture is observed in the treatment of chronic neck pain,by carrying out a randomized controlled clinical observation compared with the waiting treatment group.Methods:1.Literature research: the systematic evaluations of acupuncture treatment of chronic neck pain were searched in China National Knowledge Infrastructure(CNKI),Wanfang database,VIP database(VIP),Pub Med,Cochrane library,Web of Science and so on.The methodology quality,report quality and outcome index quality of the included system reviews were evaluated with AMSTAR2 scale,PRISMA statement and GRADE system.Furthermore,it provides a basis for the scheme design of the following clinical trial of electroacupuncture in the treatment of chronic neck pain.2.Clinical study: a prospective,randomized controlled clinical study was used.64 patients with chronic neck pain who met the inclusion criteria were randomly divided into electroacupuncture group(n=32)and waiting group(n=32)through the random number table generated by SPSS.Patients in the electroacupuncture group were given acupuncture in Fengchi,Dazhui,Jianjing,Jianzhongshu,Tianzong,by fixing an electroacupuncture in the left and right Fengchi(double)and Jianjing(double)separately.The waveform chooses the dense and sparse wave,the frequency was between 2Hz and100 Hz,the intensity was according to the patient’s tolerance,the needle was retained for 30 minutes,and then the needle was given out.The treatment cycle was 3 times per week in the first 2 weeks and 2 times per week in the last 2 weeks,with an interval of at least 1 day,30 minutes each time,and 10 times in 4 weeks.Patients in the waiting group was without acupuncture treatment during the observation period,but the patients were allowed to take prescribed painkillers or the relief methods of routine nursing care in the past when the neck pain was severe.The research group will provide 10 times of free acupuncture and moxibustion treatment for the patients after 4 weeks of observation.The primary measurement was the visual analogue score(VAS)for neck pain and discomfort between the beginning and 4 weeks after treatment,while the secondary measured were the Northwick Park Questionnaire(NPQ),the Short-form of Mc Gill Pain Questionnaire(SF-MPQ),the Neck Disability Index(NDI),neck pain grade,the Self-Rating Anxiety Scale(SAS),the Self-Rating Depression Scale(SDS),the Short-form 12-Item Health Survey(SF-12),the Physical Component Summary(PCS),Mental Component Summary(MCS),and the number of days and duration of neck pain.The scale scores were evaluated at0-4 weeks(baseline period)and 4-8 weeks(treatment period).After the test,the SPSS software was used to statistically analyze the intra-group differences in the efficacy indicators of the two groups of CNP patients and the differences between the groups after treatment,and to explore the clinical efficacy and safety of electroacupuncture in the treatment of CNP.Results:1.An overview of systematic reviews of acupuncture in the treatment of chronic neck pain:365 literatures were retrieved,and 7 SRs were finally included,whose methodological quality was between low and very low,while the quality scores of the literature reports were concentrated in the middle to high quality scores.The outcome measurement quality grading results showed that the efficacy of acupuncture and moxibustion in the treatment of CNP was better than other treatments,but the quality of the evidence were low.2.Clinical research:(1)The baselines of the two groups of subjects were consistent and comparable(P>0.05).(2)The results of measurements related to the degree of neck pain showed that compared in the intra group,the difference in the efficacy indexes of the electroacupuncture treatment group in the VAS score,NPQ score,SF-MPQ score and NDI score were extremely statistically significant(P<0.001),and the difference in the level of neck pain was statistically significant(P<0.01).While the difference in the efficacy index VAS score of the waiting group was not statistically significant(P>0.05),there was a significant difference between the NPQ score and MPQ score(P<0.01),NDI score and the difference in the level of neck pain was statistically significant(P<0.05).Compared in the inter groups,the VAS score,VAS score difference,NPQ score,NPQ score difference,SF-MPQ score,and SF-MPQ score difference after treatment in the electroacupuncture group were extremely significantly higher than the waiting treatment group(P<0.001),and the NDI score,NDI score difference of the electroacupuncture group were significantly different from the waiting group(P<0.01),and the difference in neck pain grade was statistically significant(P<0.05).(3)Neck pain frequency-related measurement results show that compared within the group,the difference in the number of days and duration of neck pain in the treatment group was extremely significant(P<0.001),while the difference in in the waiting group was not statistical significance(P>0.05).Compared between the two groups,the number of days and duration of neck pain after treatment in the electroacupuncture group were significantly better than those in the waiting group(P<0.01),and the difference in number of days and duration of neck pain was extremely significant(P<0.001).(4)The results of emotion-related measurements showed that within the group,the difference in the efficacy indicators SDS score,SAS score,and SF-MPQ score of the treatment group was statistically significant(P<0.01),the difference in the SDS score and SAS score of the waiting group were not statistically significant(P>0.05).Compared between the two groups,the SDS score and SAS score of the electroacupuncture group after treatment were not statistically significant(P>0.05),the difference in SDS score,SAS score was statistically significant(P<0.05).(5)The results of related measurement of the quality of life showed that within the group,the difference in the SF-12 score of the electroacupuncture group was extremely statistically significant(P<0.001),and the difference in the PCS score and MCS score was statistically significant(P<0.01),and the differences in SF-12,PCS,and MCS scores were not statistically significant(P>0.05).Compared between the two groups,after treatment,the PCS score of the electroacupuncture group were significantly different from the waiting group(P<0.01),and the SF-12 score difference and PCS score difference were extremely significant(P<0.001).The difference in SF-12 score was statistically significant(P<0.05),and the difference in MCS score and difference was not statistically significant(P>0.05).Conclusions:1.The overview of systematic reviews study of acupuncture treatment of chronic neck pain finds that acupuncture treatment of chronic neck pain has a significant effect,but the quality of the literature methodology and outcome indicators is low,and usually use positive drugs,traction or other interventions as baseline,which is a lack of baseline from waiting.Therefore,more high-quality evidence-based medical evidences are needed.2.This clinical trial preliminarily confirms that the electroacupuncture is safe and effective in treating CNP,and is more effective than the waiting group in improving the degree of neck pain,frequency of attacks,patients’ emotional state and quality of life.The frequency of neck pain,emotional state and quality of life of patients in the waiting treatment group did not change significantly,but the degree of neck pain tended to increase. |
PDF Full Text Request