Pain is a kind of complex physiological and psychological symptom, which makes the person debilitated and uncomfortable. Some persistent pain is unbearable for the patients, reducing the quality of life and bringing considerable pressure to the individuals and society. Pain killers seem to be effective in analgesia for patients, but their safety and addiction are crucial issues. From the theory of traditional Chinese medicine (TCM), the blocked meridian is the main cause of pain, and effective acupuncture can play a positive analgesic effect. Acupuncture that can date back thousands of years is one of the ancient medical practices in China. Its safety and effectiveness are respected. Based on its superior safety and inferior side effects, it has been gradually recognized as a therapeutic intervention method for complementary medicine, which is also generally used to treat multiple pain diseases. It is shown by modern medical studies that neurotransmitters are the material basis for the acupuncture effect, and the effect of acupuncture analgesia is related to changes in neurotransmitters. However, the specific mechanism has not been elucidated. This review aims to comprehensively discuss the historical evolution of acupuncture analgesia, clinical research of acupuncture analgesia, comparison of acupuncture and drug therapy, the neurotransmitter mechanism of acupuncture analgesia, the effect of acupuncture manipulation on analgesia, and bibliometric analysis of acupuncture treatment for pain, to explore the superiority and related mechanism of acupuncture analgesia from different aspects, and to provide a more effective treatment for alleviating patients’ pain.

Background: This study used a network meta-analysis to evaluate the efficacy of various different acupuncture types and language rehabilitation training on post-stroke dysarthria (PSD), and examined the possible mechanisms involved. There are often clinical studies comparing the effects of different acupuncture methods on dysarthria after stroke. The efficacy of these methods can be ranked by network meta-analysis. This is necessary for clinical acupoints selection. The results of this study illustrated the comparison of the therapeutic effects of 6 different acupuncture types, which can provide some reference for clinical acupoints selection and research. Methods: A comprehensive search for clinical studies related to the use of acupuncture to treat PSD was conducted in eight English and Chinese databases. Patients were divided into six groups based on the acupoints selected, namely, tongue, neck, scalp, body, combination, and traditional acupuncture. The recovery of neurological function in the patients was assessed based on the curative impact and the National Institutes of Health Stroke Scale (NIHSS) score. The quality of the included studies was evaluated using the Cochrane risk bias assessment tool and the STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) criteria. A network meta-analysis was performed using the network-meta package of Stata 15.1 software based on frequency. The heterogeneity test, consistency test, head-to-head mixed comparison, efficacy ranking, and publication bias study were all performed. Results: A total of 47 studies were finally included. There was a total of 4,197 patients in the eligible studies. The model for network meta-analysis proved robust, with minimal heterogeneity and high consistency. Combined acupuncture combined with language rehabilitation training was the most effective in treating dysarthria symptoms, followed by tongue acupuncture (TA) and nape acupuncture (NA). In addition, the combined effect of acupuncture and language training was superior to that of acupuncture alone. In terms of recovery of nerve function, traditional acupuncture and body acupuncture were more effective. To facilitate the recovery of nerve function, increasing the frequency of acupoints is necessary. Conclusions: Combined acupuncture may have the most beneficial healing effect on PSD, followed by acupuncture of the tongue and the nape of the neck. In terms of recovery of nerve function, traditional acupuncture and body acupuncture may have more effective.

Objective. To discuss whether tongue acupuncture is more effective than traditional acupuncture in the treatment of poststroke dysarthria and explore the advantage of tongue acupuncture treatment parameters. Methods. We evaluated the efficacy of tongue acupuncture compared with traditional acupuncture through a rigorous meta-analysis process. The included studies were from eight databases in English and Chinese. The Cochrane risk of bias assessment tool was used to evaluate the quality of studies. Stata15.1 software was used for meta-analysis and sensitivity analysis. Tongue acupuncture therapeutic parameters were classified and counted based on tongue acupoint location, acupuncture manipulation, and the number of manipulations. Subgroup analysis was used to compare the differences between various treatment parameters. Outcome The meta-analysis eventually included a total of 9 studies. Tongue acupuncture is superior to traditional acupuncture in clinical efficacy [OR = 3.62, 95%Cl (2.24, 5.85), ], FDA score [SMD = −1.99, 95%Cl (−3.77, −0.21), ], and NIHSS score [WMD = 0.86, 95%Cl (0.15, 1.57), , I2 = 31.7%] in the treatment of poststroke dysarthria. According to the classified statistics of tongue acupuncture treatment parameters, there are three kinds of tongue acupuncture points in 9 studies: lingual surface, sublingual, and both lingual surface and sublingual acupoints. The operation methods include the oblique stabbing of the root of the tongue, twisting after stabbing, and acupoint pricking. The number of operation methods varies from 1 to 3. Conclusion. Tongue acupuncture outperforms traditional acupuncture in terms of clinical efficacy, FDA score, and NIHSS score in the treatment of poststroke dysarthria. The curative effect of sublingual acupoints is better than that of lingual surface acupoints, the combined use of multiple manipulations is better than that of a single manipulation, and acupuncture manipulation has a cumulative effect. PROSPERO registration number: CRD42021285722.

Purpose: This meta-analysis aimed to systematically evaluate the efficacy and safety of acupuncture compared to conventional oral medications for the prophylactic treatment of migraine, following the PRISMA guidelines. Methods: Comprehensive searches of international and Chinese databases were conducted up to January 2024 using terms such as “migraine” and “acupuncture”. Two researchers independently screened studies and extracted data. Following the refinement of the inclusion criteria during the revision process, only studies focusing on the prophylactic treatment of migraine were included in the final analysis. The primary outcomes included migraine intensity, frequency of migraine attacks, number of migraine days, and the proportion of patients achieving at least a 50% reduction in migraine days. The secondary outcomes included migraine duration, the overall effective rate, and the overall effective rate at 6 months follow-up. Meta-analyses were conducted using RevMan 5.3. Results: Nineteen randomized controlled trials (2296 patients) were included. Compared to conventional medication, acupuncture was associated with greater reductions in frequency of migraine attacks (SMD = – 0.17, 95% CI [– 1.05, – 0.37]; P < 0.0001), migraine intensity (MD = – 1.48, 95% CI [– 2.51, – 0.46]; P = 0.005), number of migraine days (MD = – 1.50, 95% CI [– 2.52, – 0.48]; P = 0.004), and migraine duration (SMD = – 0.60, 95% CI [– 0.81, – 0.40]; P < 0.00001). A higher proportion of patients achieved at least a 50% reduction in migraine days (RR = 2.08, 95% CI [1.22, 3.55]; P = 0.007). Acupuncture also showed a higher overall effective rate (RR = 1.25, 95% CI [1.16, 1.35]; P < 0.00001) and overall effective rate at 6 months follow-up (RR = 1.34, 95% CI [1.19, 1.50]; P < 0.00001), with fewer adverse events reported. However, the overall quality of evidence was moderate to low. Conclusion: Acupuncture may offer potential benefits in the prophylactic treatment of migraine; however, substantial heterogeneity across studies, methodological limitations, and the moderate to low quality of evidence limit the certainty of these findings. Further high-quality randomized controlled trials are needed to confirm these results.