1 School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing 210023, P. R. China.
2 The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, P. R. China.
Am J Chin Med. 2017;45(5):965-985. doi: 10.1142/S0192415X17500513. Epub 2017 Jun 28.
Knee osteoarthritis (KOA) is a common chronic degenerative disease of the elderly. Electro-acupuncture (EA) is considered as a beneficial treatment for KOA, but the conclusion is controversial. This systematic review compiled the evidence from 11 randomized controlled trials to objectively assess the effectiveness and safety of EA for KOA. Eight databases including PubMed, Cochrane Library, Clinic trials, Foreign Medical Literature Retrial Service (FMRS), Science Direct, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang Data were extensively searched up to 5 July 2016. The outcomes included the evaluation of effectiveness, pain and physical function. Risk of bias was evaluated according to the Cochrane risk of bias tool. Eleven RCTs with 695 participants were included. Meta-analysis indicated that EA was more effective than pharmacological treatment (RR [Formula: see text] 1.14; 95% CI [Formula: see text] 1.01,1.28; [Formula: see text]) and manual acupuncture (RR [Formula: see text] 1.12; 95% CI [Formula: see text] 1.02,1.22; [Formula: see text]). Also, EA had a more significant effect in reducing the pain intensity (SMD [Formula: see text]; 95% CI [Formula: see text]; [Formula: see text]) and improving the physical function in the perspective of WOMAC (MD [Formula: see text]; 95% CI [Formula: see text], 5.56; [Formula: see text]) and LKSS (pharmacological treatment: MD [Formula: see text]; 95% CI [Formula: see text], 6.64; [Formula: see text]). Furthermore, these studies implied that EA should be performed for at least 4 weeks. Conclusively, the results indicate that EA is a great opportunity to remarkably alleviate the pain and improve the physical function of KOA patients with a low risk of adverse reaction. Therefore, more high quality RCTs with rigorous methods of design, measurement and evaluation are needed to confirm the long-term effects of EA for KOA.
膝骨关节炎（KOA）是一种常见的老年慢性退行性疾病。电针（EA）被认为是一种有益的 KOA 治疗方法，但结论存在争议。本系统评价综合了 11 项随机对照试验的证据，客观评估了 EA 治疗 KOA 的有效性和安全性。广泛检索了 PubMed、Cochrane 图书馆、临床试验、外国医学文献检索服务（FMRS）、Science Direct、中国知网（CNKI）、中文科技期刊数据库（VIP）和万方数据，检索截至 2016 年 7 月 5 日。结局包括有效性评估、疼痛和身体功能。根据 Cochrane 偏倚风险工具评估偏倚风险。纳入 11 项 RCT，共 695 名参与者。Meta 分析表明，EA 比药物治疗（RR [Formula: see text] 1.14；95%CI [Formula: see text] 1.01,1.28；[Formula: see text]）和手动针刺（RR [Formula: see text] 1.12；95%CI [Formula: see text] 1.02,1.22；[Formula: see text]）更有效。此外，在减轻疼痛强度方面（SMD [Formula: see text]；95%CI [Formula: see text]；[Formula: see text]）和改善 WOMAC（MD [Formula: see text]；95%CI [Formula: see text]，5.56；[Formula: see text]）和 LKSS（药物治疗：MD [Formula: see text]；95%CI [Formula: see text]，6.64；[Formula: see text]）方面，EA 也有更显著的效果。此外，这些研究表明 EA 应至少进行 4 周。总之，结果表明 EA 是一种很好的机会，可以显著减轻 KOA 患者的疼痛，改善其身体功能，且不良反应风险低。因此，需要更多高质量的 RCT，采用严格的设计、测量和评估方法，以确认 EA 治疗 KOA 的长期效果。
