Yang Li-Hua, Duan Pei-Bei, Hou Qing-Mei, Du Shi-Zheng, Sun Jin-Fang, Mei Si-Juan, Wang Xiao-Qing
Department of Oncology, Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, 155 Hanzhong Road, Gulou District, Nanjing, Jiangsu 210029, China.
Department of Nursing, Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, 155 Hanzhong Road, Gulou District, Nanjing, Jiangsu 210029, China.
Evid Based Complement Alternat Med. 2017;2017:6383649. doi: 10.1155/2017/6383649. Epub 2017 Jul 18.
To identify the efficacy of auricular acupressure on pain and disability for chronic LBP by systematic review.
A search of randomized controlled trials was conducted in four English medical electronic databases and three Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed using all time-points meta-analysis.
A total of 7 trials met the inclusion criteria, of which 4 had the low risk of bias. The findings of this study showed that, for the immediate effect, auricular acupressure had large, significant effects in improving pain within 12 weeks. As for the follow-up effect, the pooled estimates also showed promising effect at 4-week follow-up after 4-week intervention (standardized mean difference = -1.13, 95% CI (-1.70, -0.56), < 0.001). But, for the disability level, the therapeutic effect was not significant (mean difference = -1.99, 95% CI (-4.93, 0.95), = 0.18). No serious adverse effects were recorded.
The encouraging evidence of this study indicates that it is recommended to provide auricular acupressure to patients with chronic low back pain. However, a more accurate estimate of the effect will require further rigorously designed large-scale RCTs on chronic LBP for improving pain and disability.
通过系统评价确定耳穴按压对慢性下腰痛患者疼痛和功能障碍的疗效。
在四个英文医学电子数据库和三个中文数据库中检索随机对照试验。两名研究者独立检索相关研究,评估方法学质量,并使用标准化数据表格提取数据。采用全时间点荟萃分析进行荟萃分析。
共有7项试验符合纳入标准,其中4项偏倚风险较低。本研究结果表明,就即时效应而言,耳穴按压在改善12周内的疼痛方面具有显著的大效应。至于随访效应,汇总估计值也显示在4周干预后的4周随访中有显著效果(标准化均数差=-1.13,95%可信区间(-1.70,-0.56),P<0.001)。但是,对于功能障碍水平,治疗效果不显著(均数差=-1.99,95%可信区间(-4.93,0.95),P=0.18)。未记录到严重不良反应。
本研究的令人鼓舞的证据表明,建议为慢性下腰痛患者提供耳穴按压。然而,要更准确地评估其效果,还需要进一步针对慢性下腰痛进行更严格设计的大规模随机对照试验,以改善疼痛和功能障碍。