Acupuncture for primary trigeminal neuralgia: A systematic review and PRISMA-compliant meta-analysis

Background and purpose: Acupuncture is increasingly used by patients with primary trigeminal neuralgia (PTN). We aimed to evaluate the efficacy and safety of acupuncture for PTN. Methods: Seven databases were searched. Risk of bias was assessed and meta-analyses were conducted. The evidence level was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results: Thirty-three RCTs were included. Meta-analysis results demonstrated that the effect of both manual acupuncture (MA) and electro-acupuncture (EA) for improving response rate and recurrence rate was more significant than carbamazepine. Besides, MA achieved more significant effect on alleviating pain intensity. Moreover, acupuncture combined with carbamazepine had a more positive effect on response rate than carbamazepine alone. Conclusions: Acupuncture might have some positive effects for PTN. Nevertheless, the level of all evidence was low or very low. We could not yet draw a firm conclusion on the efficacy of acupuncture for PTN.