SYSTEMATIC REVIEW article
Front. Med.
Sec. Family Medicine and Primary Care
This article is part of the Research TopicAdvancements and Optimization of Evidence-Based Approaches in Pain ManagementView all 13 articles
Acupuncture combined therapy for treatment of nape dorsal myofascial pain syndrome: meta-analysis, systematic evaluation and GRADE evaluation
Provisionally accepted
- Changchun University of Chinese Medicine, Changchun, China
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Objective: To assess the therapeutic efficacy and safety risks of acupuncture combined therapy in nape dorsal myofascial pain syndrome management. Methods: Clinical randomized controlled trials of acupuncture combined therapy for nape dorsal myofascial pain syndrome were retrieved from databases such as China National Knowledge Infrastructure (CNKI), VIP Chinese Journal Platform, Wanfang Data, SinoMed, Web of Science, PubMed, Embase, and Scopus, covering publications from respective inception dates until February 26, 2025. Methodological quality appraisal involved dual assessments: GRADEprofiler 3.6 evaluated evidence certainty, while the Cochrane RoB 2.0 tool analyzed bias risk. Statistical computations encompassed meta-analysis, heterogeneity analysis, sensitivity analysis, subgroup analysis, publication bias analysis, and trim and fill methods were performed using StataSE 15, stateMP 18, and RevMan 5.4. Results: The systematic review incorporated 21 randomized controlled trials with a pooled cohort of 1,630 patients. ➀Meta-analysis revealed that compared with control groups, acupuncture combined therapy can improve VAS score [SMD=-1.51,95%CI(- 2.12, -0.90), P<0.00001], clinical effective rate [RR=1.15,95%CI (1.1, 1.2), P<0.00001], improve ROM flexion[MD=7.76,95%CI (0.64,14.88), P=0.03], PRI score[MD=-0.45,95%CI(-0.52,-0.38), P<0.00001)] and Oswestry score [MD=- 0.30,95%CI(-0.59,-0.01), P=0.05].➁Subgroup analysis indicated that acupuncture combined therapy demonstrated greater efficacy in pain reduction and cervical dysfunction improvement for patients with a mean age>35 years. ➂Publication bias analysis identified potential bias for the VAS score and clinical effective rate, which may affect the reliability of VAS conclusions but not the clinical effective rate. Conclusion: Acupuncture combined therapy demonstrates clinically significant short-term benefits for nape dorsal MPS in pain relief and clinical effective rate. Existing limited evidence shows a low incidence of adverse events, but the risk profile cannot be fully clarified due to insufficient safety reporting in most studies. Future rigorously designed, high-quality studies with diverse populations are needed to verify these findings.
Keywords: acupuncture combined therapy, nape dorsal myofascial pain syndrome, randomized controlled trials, Meta-analysis, Grade evaluation, System evaluation
Received: 03 Aug 2025; Accepted: 21 Nov 2025.
Copyright: © 2025 Zhang, Zhang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jingli Liu, ljldr2006@126.com
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