ReviewAcupuncture for fibromyalgia: An evidence map 针灸治疗纤维肌痛:证据图

Fibromyalgia (FM) is a musculoskeletal disorder characterized by chronic widespread pain accompanied by one or more concomitant symptoms, including fatigue, sleep disturbance, headache, soft tissue tenderness, stiffness, and mood disorders [1]. The prevalence of FM in the general population ranges from 2% to 4.5% [2]. The authors of a recent study published in Annals of Internal Medicine recommend a patient-appropriate treatment approach based on the key symptoms of FM. Treatment options for FM include non-pharmacologic therapy, such as physical activity, cognitive-behavioral interventions, and acupuncture, and medications such as tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and gabapentinoids [3]. As medications show modest benefits and are associated with significant side effects [4], active non-pharmacological treatment is the primary treatment modality for FM [3].

Acupuncture has received considerable attention as a treatment for FM because it does not have the side effects as pharmacological therapies. This increasing attention is evident in the rapidly increasing number of systematic reviews (SRs) and randomized clinical trials (RCTs) on acupuncture for FM. In fact, acupuncture is recommended as a treatment option in FM treatment guideline [5]. However, several studies on acupuncture for FM have duplicate, controversial, or conflicting results. In addition, different acupuncture modalities were utilized in these studies, and the primary outcomes of the studies vary. For example, the results of one SR indicated that acupuncture is more effective than sham acupuncture in improving relevant symptoms [6], whereas the findings of another SR suggested that there is insufficient evidence to prove the efficacy of acupuncture for FM compared with sham acupuncture [7]. In addition, neither original studies nor SRs are suitable for identifying important evidence gaps.

Evidence maps have been used to identify high-priority research questions, such as in the Cochrane Collaboration [8] and Agency for Healthcare Research and Quality studies [9]. The main purpose of evidence maps is to provide a broad overview of the current state of the existing research and identify gaps in the body of evidence. Evidence maps can summarize complex interventions and standardize information regarding the current state of the available evidence, its uncertainties, and its gaps. An evidence map is a concise, clear, and transparent method that can be used by policymakers, practitioners, and researchers to identify review questions relevant to policies and practices.

In this study, we present the results of an evidence map of the use of acupuncture for the treatment of FM to provide an overview of existing studies, assess the current status of the research, and identify evidence gaps.

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