Table 1.
Characteristics of the included studies.
| Intervention | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Study ID | Sample size (E/C) | Mean age (yrs) (E/C) | Experimental group | Control group | Frequency, duration | Treatment period (weeks) | Outcome | Results | Adverse event (n) |
| Acupuncture | |||||||||
| Ho 2017[41] | 77/77 | 45.53 ± 8.74/44.51 ± 9.48 | MA | SA | 3 times per week, 30 min | 2 | VAS, NPQ, SF-36 | 1. VAS: E > C (P < .001) | No serious AEs. |
| 2. NPQ: E > C (P = .008) | E: local transient bruises (n = 11) | ||||||||
| 3. SF-36: E > C (P = .003) | |||||||||
| Tekin 2013[33] | 22/17 | 42.9 ± 10.9/ 42.0 ± 12.0 | MA | SA | Twice per week (2 weeks), once per week (until end point) | 4 | VAS, SF-36 | 1. VAS: E > C (P = .000) | NR |
| 2. SF-36: E > C (P < .05) | |||||||||
| Chou 2011[35] | 15/15 | 34.1 ± 10.7/ 33.9 ± 8.3 | MA | SA | NR | 1 day | NRS, PPT, ROM, mean amplitude of EPN | 1. NRS: E > C | NR |
| 2. PPT: E > C | |||||||||
| 3. ROM: E > C | |||||||||
| 4. Mean amplitude of EPN : E > C (all P < .05) | |||||||||
| Nabeta 2002[36] | 17/17 | 34.2 ± 10.8/ 30.8 ± 12.0 | MA | SA | Once a week, 5 min | 3 | VAS, PPT | 1. VAS: E = C | NR |
| 2. PPT: E > C (P < .05) | |||||||||
| Irnich 2001[37] | 56/61 | 52.3 ± 13.3/52.2 ± 13.2 | MA | SA | 5 times, 30 min | 3 | VAS, ROM, SF-36 | 1. VAS: E = C | No serious AEs. |
| 2. ROM: E = C | Mild reactions (sweating, low blood pressure): E (n = 17), C (n = 12) | ||||||||
| 3. SF-36: E = C | |||||||||
| Raeissadat 2018[24] | 23/22 | 41.6 ± 6.8/39.4 ± 7.7 | MA | WM (2cc of 2% lidocaine injection) | Once per week | 3 | VAS, PPT, ROM, NDI | 1. VAS: E < C | No serious AEs. |
| 2. PPT: E < C | E: local transient flare reaction (n = 1) | ||||||||
| 3. ROM: E < C | |||||||||
| 4. NDI: E < C (all P > .05) | |||||||||
| Wang 2015[42] | 51/47 | 43 ± 12/48 ± 9 | MA | WM(medical solution 2 mL injection; 2.5 mL of 2% lidocaine, 500 mg of mecobalamin, 2.5 mg of dexamethasone sodium phosphate, 12 mL of 0.9% saline) | 5 times per week, 30 min | 2 | VAS, rotate-cervix test positive, dizziness score, efficacy rate | 1. VAS: E > C | No serious AEs. |
| 2. Rotate-cervix test positive: E > C | Subcutaneous blood stasis in both groups. | ||||||||
| 3. Dizziness score: E > C | |||||||||
| 4. Efficacy rate: E > C (all P < .05) | |||||||||
| Cho 2014[38] | 15/15 | 39.1 ± 9.0/38.2 ± 10.2 | MA | WM (zaltoprofen 80 mg daily, 3 times per day) | 3 times per week, 15 min | 3 | VAS, NDI, BDI, SF-36, EQ-5D | 1. VAS: E = C | None |
| 2. NDI: E = C | |||||||||
| 3. BDI: E = C | |||||||||
| 4. SF-36: E = C | |||||||||
| 5. EQ-5D: E = C | |||||||||
| Fu 2005[43] | 55/47 | 34.20 ± 7.61/ 35.24 ± 6.67 | MA | WM (0.1 mL lidocaine, injected into each acupoint, twice a week, total 4 week) | Twice a week, | 4 | efficacy rate, VAS, PRI, dizziness score | 1. Efficacy rate: E > C | None |
| 30 min | (P = .006) | ||||||||
| 2. VAS: E = C | |||||||||
| 3. PRI: E > C (P < .05) | |||||||||
| 4. Dizziness score: E > C (P < .05) | |||||||||
| Tabatabaiee 2019[25] | 20/20/20 | 23.6 ± 1.81/ | MA | C1: UC (Pressure release) | Twice per week, | 3–4 | ROM, PPT, VAS | 1. ROM: E = C2 > C1 | NR |
| C1: 23.5 ± 1.6 | C2: WM(Phonophoresis with betamethasone) | No retention | (7 times) | 2. PPT: E = C2 > C1 | |||||
| C2: 23.9 ± 3.09 | 3 times per week | 3. VAS: E = C2 > C1 (all P < .001) | |||||||
| Nejati 2021[26] | 37/38 | 40.62 ± 8.52/ 47.32 ± 10.23 | MA | UC (stretching, strengthening exercises) | Twice per week | 6 | NDI, Neck pain and disability scale | 1. NDI: E = C | None |
| 2. Neck pain and disability scale: E = C | |||||||||
| Arias-Buria 2020[30] | 15/15 | 21 ± 3/22 ± 2 | MA | UC (pressure release) | 1 time, | 1 day | NRS, NDI, inspiratory vital capacity | 1. NRS: E = C | None |
| no retention | 2. NDI: E = C | ||||||||
| 3. Inspiratory vital capacity: E > C (P < .05) | |||||||||
| Ziaeifer 2019[27] | 16/17 | 30.06 ± 9.87/ | MA | UC (pressure release) | 3 times per week, no retention | 1 | VAS, DASH, NPQ | 1. VAS: E > C (P = .02) | NR |
| 26.5 ± 8.57 | 2. DASH: E = C | ||||||||
| 3. NPQ: E = C | |||||||||
| Meulemeester 2017[39] | 20/22 | 36.1 ± 10.7/40.5 ± 8.3 | MA | UC (pressure release) | Once per week, | 4 | NDI, NRS, PPT, tone, elasticity, stiffness | 1. NDI: E = C | No serious AEs. |
| No retention | 2. NRS: E = C | E: postneedling soreness | |||||||
| 3. PPT: E = C | |||||||||
| 4. Tone: E = C | |||||||||
| 5. Elasticity: E = C | |||||||||
| 6. Stiffness: E = C | |||||||||
| Ziaeifer 2016[28] | 14/17 | 30.78 ± 10.39/26.69 ± 9.4 | MA | UC (ischemic compression) | 3 times per week | 1 | VAS, PPT | 1. VAS: E < C | NR |
| (48-hour interval between sessions) for each group | 2. PPT: E < C | ||||||||
| Hayta 2016[34] | 28/27 | NR | MA | UC (Kinesiotaping) | Twice per week | 2 | VAS, NDI, Nottingham Health Profile | 1. VAS: E = C | NR |
| 10–20 min | 2. NDI: E = C | ||||||||
| 3. Nottingham Health Profile: E = C | |||||||||
| Ziaeifer 2014[29] | 16/17 | 30.06 ± 9.87/ 26.50 ± 8.57 | MA | UC (ischemic compression) | 3 times per week, no retention | 1 | VAS, PPT, DASH | 1. VAS: E > C (P = .01) | NR |
| 2. PPT: E = C | |||||||||
| 3. DASH: E = C | |||||||||
| Fu 2013[44] | 30/30 | 41.53 ± 9.41/42.57 ± 10.32 | MA | UC (McKenzie exercise) | 5 times per week, 30 min | 2 | Efficacy rate, cervical spine function assessment (total, clinical symptoms, clinical examination, daily life actions) | 1. Efficacy rate: E > C (P < .05) | NR |
| 2. Cervical spine function assessment | |||||||||
| - Total score: E > C | |||||||||
| (P < .001) | |||||||||
| - Clinical symptoms: | |||||||||
| E > C (P < .05) | |||||||||
| - Clinical examination: | |||||||||
| E > C (P < .05) | |||||||||
| - Daily life actions: E = C | |||||||||
| Mejuto-Vazquez 2014[31] | 9/8 | 25 ± 4/24 ± 7 | MA | NT | No retention | 1 day | NRS, PPT, ROM | 1. NRS: E > C (P < .01) | No serious AEs. |
| 2. PPT: E > C (P < .01) | E:postneedling soreness (n = 8) | ||||||||
| 3. ROM: E > C (P < .01) | |||||||||
| Electroacupuncture | |||||||||
| Chen 2019[40] | 46/33/30 | mean 55/ | EA | C1: SA | Twice per week, 30 min | 3 | VAS, SF-36 | 1. VAS | No serious AEs. |
| C1: mean 53/C2: mean 51 | C2: NT | E = C1 | E: acupuncture-related | ||||||
| E > C2 (P = .003) | uncomfortableness (n = 1) | ||||||||
| C1 = C2 | |||||||||
| 2. SF-36 | |||||||||
| - physical functioning, pain | |||||||||
| E = C1 | |||||||||
| E > C2 (P = .001) | |||||||||
| C1 = C2 | |||||||||
| - role functioning/physical | |||||||||
| E = C1 | |||||||||
| E > C2 (P = .032) | |||||||||
| C1 = C2 | |||||||||
| - role functioning/emotional, social functioning, emotional well-being | |||||||||
| E = C1 | |||||||||
| E = C2 | |||||||||
| C1 = C2 | |||||||||
| - Energy/fatigue | |||||||||
| E = C1 | |||||||||
| E > C2 (P = .007) | |||||||||
| C1 = C2 | |||||||||
| - general health E = C1 | |||||||||
| E > C2 (P = .03) | |||||||||
| C1 = C2 | |||||||||
| Cui 2016[45] | 37/30 | 47.03 ± 14.19/49.27 ± 10.96 | EA | SA | 3 times per week, 30 min | 4 | NPQ, MPQ, SF-36, efficacy rate | 1. NPQ: E = C | None |
| 2. MPQ: E = C | |||||||||
| 3. SF-36: E = C | |||||||||
| 4. Efficacy rate: E = C | |||||||||
| Feng 2014[46] | 17/18/19 | 20–60 | EA | C1: SA | 3 times per week, 30 min | 4 | NPQ, MPQ, VAS, PPT | 1. NPQ: E > C1 = C2 | NR |
| C2: NT | 2. MPQ: E > C1 = C2 | ||||||||
| 3. VAS: E > C1 = C2 | |||||||||
| 4. PPT: E > C1 = C2 (all P < .05) | |||||||||
| Zhang 2013[47] | 103/103 | mean 45.8 | EA | SA | 3 times per week, 45 min | 3 | NPQ, symptom score, SF-36 | 1. NPQ: E = C | No serious AEs. |
| 2. Symptom score: E = C | E:increased neck pain (n = 1), headache (n = 2), dizziness (n = 1), pain at acupuncture point (n = 1),local transient bruises(n = 2), chest discomfort (n = 1) | ||||||||
| 3. SF-36: E = C | C:increased neck pain (n = 2), headache (n = 1), dizziness (n = 1), itching palm (n = 1), warmth at the back (n = 1) | ||||||||
| Li 2008[48] | 42/52 | E: 47.40 ± 8.75 | EA | WM (Fenbid capsules 300 mg, once a day) | Once every other day, 20 min | 3 | efficacy rate | 1. Efficacy rate: E > C (P < .05) | NR |
| C: NR | |||||||||
| Yan 2006[49] | 78/78 | mean 48.5/47.3 | EA | WM (Ibuprofen 2 tablets, enteric-coated aspirin tablets 0.3g, vitamin B1, 20 mg, twice per day) | Once per day, 30 min | 10 days | efficacy rate | 1. Efficacy rate: E > C (P < .01) | NR |
| Diethelm 2014[50] | 30/30 | 42.27 ± 11.79/50.77 ± 10.79 | EA | UC (Kinesiotaping) | Twice per week, 30 min | 4 | VAS, MPQ, efficacy rate | 1. VAS: E > C (P = .016) | NR |
| 2. MPQ: E > C (P < .01) | |||||||||
| 3. Efficacy rate: E > C (P < .05) | |||||||||
| Yang 2020[51] | 30/30 | total 47.63 ± 3.72 | EA | MA | 3 times per week, 30 min | 4 | Cervical spondylosis symptom scale, VAS, NDI, Serum IL-6, efficacy rate | 1. Cervical spondylosis symptom scale: E > C (P < .01) | NR |
| 2. VAS: E > C (P < .01) | |||||||||
| 3. NDI: E > C (P < .01) | |||||||||
| 4. Serum IL-6 (P < .01) | |||||||||
| 5. Efficacy rate (P < .05) | |||||||||
| Garcia-De-Miguel 2020[32] | 22/22 | 24.14 ± 9.39/25.45 ± 8.53 | EA | MA | 1 time, | 1 day | VAS, NDI, PPT, ROM, Side bending strength | 1. VAS: E = C | NR |
| E: 20 min, | 2. NDI: E > C (P < .05) | ||||||||
| C: no retention | 3. PPT: E > C (P < .01) | ||||||||
| 4. ROM: E = C | |||||||||
| 5. Side bending strength: E = C | |||||||||
| Huang 2018[52] | 45/45 | 41 ± 10/42 ± 9 | EA | MA | once every other day, 20 min | 3 | symptom and physical sign score, VAS, efficacy rate | 1. Symptom and physical sign score: E > C | NR |
| 2. VAS: E > C | |||||||||
| 3. Efficacy rate: E > C (all P < .05) | |||||||||
| Chen Y 2016[53] | 30/30 | mean 45/45 | EA | MA | once every other day, 30 min | 4 | TTYS, MPQ, efficacy rate | 1. TTYS: E > C (P < .05) | None |
| 2. MPQ: E > C (P < .05) | |||||||||
| 3. Efficacy rate: E > C (P < .05) | |||||||||
| Chen G 2016[54] | 30/30 | 32.83 ± 8.94/ 34.66 ± 8.92 | EA | MA | once per day, 30 min | 1 | PPI, PRI, | 1. PPI: E > C | NR |
| VAS, ROM, efficacy rate, symptom and sign score | 2. PRI: E > C | ||||||||
| 3.VAS: E > C | |||||||||
| 4. ROM: E > C | |||||||||
| 5. Efficacy rate: E > C | |||||||||
| 6. Symptom and sign score: E > C (all P < .05) | |||||||||
| Tian 2015[55] | 30/30 | 39.12 ± 7.85/ 41.33 ± 9.33 | EA | MA | once per day, | 4 | NPQ, MPQ | 1. NPQ: E > C (P < .01) | NR |
| 30 min | efficacy rate | 2. MPQ: E > C (P < .01) | |||||||
| 3. Efficacy rate: E = C | |||||||||
| Chen 2015[56] | 30/30 | 31–75 | EA | MA | once per day, 30 min | 4 | efficacy rate, PRI, VAS, PPI, mean treatment time | 1. Efficacy rate: E = C | NR |
| 2. PRI: E > C (P < .01) | |||||||||
| 3.VAS: E > C (P < .01) | |||||||||
| 4. PPI: E > C (P < .01) | |||||||||
| 5. Mean treatment time: E > C (P < .01) | |||||||||
| Liu 2014[57] | 30/30 | 43.27 ± 11.67/ 40.23 ± 11.37 | EA | MA | once per day, 30 min | 3 | symptom and sign score, MPQ, F wave conduction velocity (median nerve, ulnar nerve), efficacy rate | 1.Symptom and sign score: E > C | NR |
| 2. MPQ: E > C | |||||||||
| 3. F wave conduction velocity: E > C | |||||||||
| 4. Efficacy rate: E > C (all P < .05) | |||||||||
| Jin 2013[58] | 30/30 | 44.60 ± 1.78/ 41.10 ± 1.94 | EA | MA | once per day, | 2 | efficacy rate, PRI, VAS, | 1. Efficacy rate: E = C | No serious AEs. |
| 30 min | PPI, TTYS | 2. PRI: E = C | Anxiety in both groups. | ||||||
| 3. VAS: E = C | |||||||||
| 4. PPI: E = C | |||||||||
| 5. TTYS: E > C (P < .05) | |||||||||
| Zhang 2011[59] | 57/49 | 21–77 | EA | MA | once per day, 30 min | 3 | efficacy rate, curative rate | 1. Efficacy rate: E = C | NR |
| 2. Curative rate: E > C (P < .05) | |||||||||
| Yang 2011[60] | 36/36 | 42.18/41.32 | EA | MA | 5 times per week, 30 min | 4 | VAS, efficacy rate | 1. VAS: E > C (P < .01) | NR |
| 2. Efficacy rate: E > C (P < .05) | |||||||||
| Ji 2015[61] | 29/29 | NR | EA | MA | 5 times per week, 30 min | 4 | NPQ, VAS, SF-36 | 1. NPQ: E > C | NR |
| 2. VAS: E > C3. SF-36: E > C (all P < .05) | |||||||||
| Wang 2010[62] | 35/35 | 38.29 ± 10.72/ 36.96 ± 11.21 | EA | MA | once every other day, 20 min | 10 days | NPQ, MPQ, VAS, SF-36, efficacy rate | 1. NPQ: E > C (P < .01) | None |
| 2. MPQ: E > C (P < .01) | |||||||||
| 3. VAS: E > C (P < .01) | |||||||||
| 4. SF-36: E > C (P < .05) (except physical functioning and role physical: E = C) | |||||||||
| 5. Efficacy rate: E > C (P = .03) | |||||||||
| Liu 2010[63] | 30/30 | 40.93 ± 11.25/ 42.03 ± 11.61 | EA | MA | once per day, 30 min | 3 | symptom and sign score, efficacy rate, PRI | 1.Symptom and sign score: E > C | NR |
| 2. Efficacy rate: E > C | |||||||||
| 3. PRI: E > C (all P < .05) | |||||||||
| Lai 2010[64] | 35/35 | NR | EA | MA | once per day, | 4 | symptom score, Chinese medicine symptom score, VAS, PRI, PPI, efficacy rate | 1. Symptom score: E > C | None |
| 30 min | 2 Chinese medicine symptom score: E > C | ||||||||
| 3. VAS: E > C | |||||||||
| 4. PRI: E > C | |||||||||
| 5. PPI: E > C (1–5 all P < .01) | |||||||||
| 6. Efficacy rate: E = C | |||||||||
| Yang 2009[65] | 100/100 | 23–77 | EA | MA | once per day, 30 min | 10–30 days | efficacy rate, | 1. Efficacy rate: E > C | NR |
| curative rate | 2. Curative rate: E > C (all P < .05) | ||||||||
| Ding 2009[66] | 30/30 | 41.05 ± 9.65/42.50 ± 7.63 | EA | MA | 5 times per week, 30 min | 3 | symptoms scores, efficacy rate | 1. Symptoms scores: E > C (P < .01) | NR |
| 2. Efficacy rate: E > C (P < .05) | |||||||||
| Yu 2007[67] | 30/30 | 46.19 ± 10.88/ 43.64 ± 14.63 | EA | MA | once per day, | 3 | symptom and sign score, PRI, VAS, PPI, efficacy rate | 1. Symptom and sign score: E > C (P < .05) | NR |
| 30 min | 2. PRI: E > C (P < .001) | ||||||||
| 3. VAS: E > C (P < .05) | |||||||||
| 4. PPI: E > C (P < .001) | |||||||||
| 5. Efficacy rate: E > C (P < .05) | |||||||||
| Warm acupuncture | |||||||||
| Chen 2020[68] | 40/40 | NR | WA | MA | once every other day, 20–30 min | 6 | efficacy rate, symptoms score, SF-36, NPQ, VAS | 1. Efficacy rate: E > C | None |
| 2. Symptoms score: E > C | |||||||||
| 3. NPQ: E > C | |||||||||
| 4. VAS: E > C | |||||||||
| 5. SF-36: E > C (all P < .05) | |||||||||
| Ju 2019[69] | 60/60 | 48.55 ± 11.63/ 46.27 ± 11.51 | WA | MA | E: once per week, 20 min | 3 | assessment scale for cervical spondylosis, improvement index, improvement rate, symptom score, VAS | 1. Assessment scale for cervical spondylosis: E > C (P < .01) | None |
| C: 6 times per week, 30 min | 2. Improvement index: E = C | ||||||||
| 3. Improvement rate: E = C | |||||||||
| 4. Symptom score: E > C (P < .01) | |||||||||
| 5. VAS: WA > MA(P < .01) | |||||||||
| Xu 2017[70] | 110/110 | 56.2 ± 9.4/ | WA | MA | twice per day | 2 | efficacy rate, VAS | 1. Efficacy rate: E > C | NR |
| 56.4 ± 9.3 | 2. VAS: E > C (all P < .05) | ||||||||
| Guo 2015[71] | 30/30 | 24.07 ± 3.41/ 24.70 ± 2.95 | WA | MA | once every other day, 30 min | 2 | NPQ, MPQ, efficacy rate | 1. NPQ: E > C (P < .05) | None |
| 2. MPQ: E > C (P < .01) | |||||||||
| 3. Efficacy rate: E > C (P < .05) | |||||||||
| Zhou 2014[72] | 30/30 | mean 39.2/43.3 | WA | MA | once per day, | 10 days | efficacy rate, TTYS, VAS | 1. Efficacy rate: E > C | None |
| 30 min | 2. TTYS: E > C3. VAS: E > C (all P < .05) | ||||||||
| Lin Z 2012[73] | 40/40 | mean 60.25/58.24 | WA | MA | once every other day | 9 | TTYS, efficacy rate | 1. TTYS: E > C (P < .05) | NR |
| 2. Efficacy rate: E = C | |||||||||
| Garov 2016[74] | 30/30 | 42.81 ± 12.76/ 40.45 ± 12.99 | WA | EA | 5 times per week, 30 min | 2 | TTYS, VAS | 1. TTYS: E = C | E: subcutaneous bleeding (n = 1), burn (n = 1)C: subcutaneous bleeding (n = 1), dizziness (n = 1) |
| 2. VAS: E = C | |||||||||
| Su 2015[75] | 30/30 | 39 ± 11/44 ± 12 | WA | EA | once every other day, 20 min | 2 | PRI, VAS, PPI, efficacy rate, the counts of red and yellow tender points | 1. PRI: E > C | NR |
| 2. VAS: E > C | |||||||||
| 3. PPI: E > C | |||||||||
| 4. Efficacy rate: E > C | |||||||||
| 5. The counts of red tender points: E > C | |||||||||
| 6. The counts of yellow tender points: E > C (all P < .05) | |||||||||
| Lin J 2012[76] | 30/30 | 18–65 | WA | EA | once every other day, 30 min | 4 | VAS, NPQ, efficacy rate | 1. VAS: E > C (P = .01) | None |
| 2. NPQ: E > C (P = .04) | |||||||||
| 3. Efficacy rate: E = C | |||||||||
| Fire acupuncture | |||||||||
| Qui 2015[77] | 31/31 | 44.12 ± 11.21/ | FA | MA | E: twice per week, no retention | 3 | symptom and sign scores, efficacy rate | 1. Symptom and sign score: E > C (P < .05) | NR |
| 43.58 ± 10.02 | C: once per day, 30 min | 2. Efficacy rate: E > C (P < .05) | |||||||
| Sun 2015[78] | 100/100 | 46 ± 12/46 ± 14 | FA | MA | once per day | 3 | VAS, PPI, PRI, | 1. VAS: E > C | NR |
| E: no retention | efficacy rate | 2. PPI: E > C | |||||||
| C: 20 min | 3. PRI: E > C | ||||||||
| 4. Efficacy rate: E > C (all P < .01) | |||||||||
| Zhao 2013[79] | 30/30 | 18–60 | FA | EA | E: once per 5 days, no retention | 4 | MPQ, NPQ, NDI, EMG (trapezius muscle, sternocleidomastoid muscle), efficacy rate | 1. MPQ: E > C (P < .01) | NR |
| 2. NPQ: E > C (P < .01) | |||||||||
| C: once per day, 30 min | 3. NDI: E > C (P < .05) | ||||||||
| 4. EMG: E = C | |||||||||
| 5. Efficacy rate: E > C (P < .01) | |||||||||
| Acupoint catgut embedding | |||||||||
| Cheng 2018[80] | 73/73 | 52.8 ± 5.2/ | ACE | MA | E: once every 15 days | 4 | symptoms scores, efficacy rate | 1. Symptoms scores: E > C (P < .05) | NR |
| 51.5 ± 5.2 | C: once per day, 30 min | 2. Efficacy rate: E > C (P < .05) | |||||||
| Qui C 2015[81] | 63/63 | 38 ± 8/37 ± 9 | ACE | MA | E: once per 2 weeks | 4 | efficacy rate | 1. Efficacy rate: E > C (P < .05) | NR |
| C: once per day, 20–30 min | |||||||||
| Wang 2016[82] | 35/35 | mean 52/54 | ACE | MA | E: once per week | 3 | symptom and sign score, VAS, PPI, efficacy rate | 1.Symptom and sign score: E = C | NR |
| C: once per day, 20 min | 2. VAS: E = C | ||||||||
| 3. PPI: E > C (P < .05) | |||||||||
| 4. Efficacy rate: E > C (P < .05) | |||||||||
| Li 2015[83] | 43/43 | 56.3 ± 8.5/ 57.1 ± 7.3 | ACE | MA | E: once per week | 4 | clinical symptoms and function evaluation, VAS, PRI, PPI, efficacy rate | 1. Clinical symptoms and function evaluation: E > C | NR |
| C: once per day, 30 min | 2. VAS: E > C | ||||||||
| 3. PRI: E > C | |||||||||
| 4. PPI: E > C | |||||||||
| 5. Efficacy rate: E > C (all P < .05) | |||||||||
| Zhao 2015[84] | 60/60 | 27.5 ± 2.4/ 28.0 ± 2.6 | ACE | MA | once per day C: 30 min | 10 days | efficacy rate | 1. Efficacy rate: E > C (P < .01) | NR |
| Ding 2012[85] | 58/62 | 29 ± 8/30 ± 9 | ACE | MA | E: once per week | 2 | efficacy rate, NDI, VAS | 1. Efficacy rate: E > C | NR |
| C: once per day, 30 min | 2. NDI: E > C3. VAS: E > C (all P < .05) | ||||||||
| Feng 2012[86] | 117/98 | 38.9 ± 7.6/ | ACE | MA | E: once per 2 weeks | 4 | NDI, VAS | 1. NDI: E > C (P < .05) | NR |
| 40.1 ± 8.7 | C: once every other day, 30 min | 2. VAS: E > C (P < .05) | |||||||
| Xian 2012[87] | 30/30 | 48.70 ± 7.15/47.53 ± 7.31 | ACE | MA | E: once per week | 2 | Cervical spondylosis score, MPQ, efficacy rate | 1. Cervical spondylosis score: E > C (P = .01) | No serious AEs. |
| C: 6 times per week, 30 min | 2. MPQ: E > C (P < .01) | E:subcutaneous bleeding (n = 2) | |||||||
| 3. Efficacy rate: E > C (P = .01) | |||||||||
| Zou 2016[88] | 30/30 | 49.67 ± 7.95/50.73 ± 7.60 | ACE | MA | E: once per week | 4 | Cervical spondylopathy symptoms and function evaluation scale, MPQ, efficacy rate | 1. Cervical Spondylopathy Symptoms and Function Evaluation Scale: E > C (P = .03) | NR |
| C: once per day, 15–20 min | 2. MPQ: E > C (P = .03) | ||||||||
| 3. Efficacy rate: E > C (P = .03) | |||||||||
E, experimental group; C, control group. The total efficacy rate was calculated as the number of cured and improved cases.ACE, acupoint catgut embedding; AE, adverse event; BDI, Beck Depression Inventory; DASH, Disabilities of the Arm, Shoulder, and Hand Questionnaire; EA, electroacupuncture; EMG, Electromyography; EPN, the end-plate noise; EQ-5D, Euroqol 5D health utility; FA, fire acupuncture; IL, interleukin; MA, manual acupuncture; MPQ, McGill Pain Questionnaire; NDI, Neck Disability Index; NPQ, Neck Pain Questionnaire; NR, not reported; NRS, numeral rating scale; NT, no treatment; PPI, present pain intensity; PPT, pain pressure threshold; PRI, pain rating index; ROM, range of motion; SA, sham acupuncture; SF-36, 36-Item Short Form Health Survey; TTYS, Total Tanaka Yasuku Score; UC, usual care; VAS, Visual Analog Scale; WA, warm acupuncture; WM, Western medicine.