Second Clinical Department, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong Province, China.
Acupuncture and Moxibustion Department, Guangdong Province Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong Province, China.
Acupunct Med. 2018 Aug;36(4):215-221. doi: 10.1136/acupmed-2016-011227. Epub 2018 Jul 9.
Warm needle acupuncture (WNA) is commonly used in primary osteoporosis (OP) management in China. The evidence of its effectiveness needs to be systematically reviewed.
The aim of the meta-analysis was to evaluate whether using WNA alone or combined with conventional medicine benefits primary OP.
PubMed, Embase, the Cochrane Central Register, Medline, China National Knowledge Infrastructure, Wanfang and VIP databases were searched from their inception through 30 June 2016. RCTs applying WNA independently or as an adjunct to conventional medicine, compared with conventional medicine alone, were included. Primary outcomes were bone mineral density (BMD) of the lumbar vertebrae, femoral neck, Ward's triangle and greater trochanter. The secondary outcome was chronic pain measured by VAS score. Meta-analysis was conducted using RevMan V.5.3 software.
Nine RCTs involving 572 participants were included. When WNA was used as an adjunct to conventional medicine, meta-analysis revealed a statistical difference in favour of increasing BMD of the lumbar vertebrae (mean difference (MD)=0.06, 95% CI 0.03 to 0.08, P<0.001). WNA increased BMD of the femoral neck (MD 0.14, 95% CI 0.08 to 0.21, P<0.001) and greater trochanter (MD 0.09, 95% CI 0.04 to 0.15, P<0.001) when used alone, and additionally decreased VAS scores (MD=-1.10, 95% CI -1.14 to -1.06, P<0.001) when used as an adjunct to conventional medicine. However, the safety of WNA was not specifically reported.
WNA may have beneficial effects on BMD and VAS scores of patients with primary OP. However, all included trials were at high risk of bias and of low quality. Further rigorous studies are needed to determine the effectiveness of WNA for primary OP treatment.
温针疗法（WNA）常用于中国原发性骨质疏松症（OP）的治疗。需要系统评价其有效性的证据。
本荟萃分析的目的是评估单独使用 WNA 或与常规药物联合使用是否有益于原发性 OP。
检索 PubMed、Embase、Cochrane 中央注册、Medline、中国知网、万方和 VIP 数据库，检索时间截至 2016 年 6 月 30 日。纳入独立应用 WNA 或作为常规药物辅助治疗与单纯常规药物治疗比较的 RCT。主要结局指标为腰椎、股骨颈、Ward 三角和大转子的骨密度（BMD）。次要结局指标为疼痛视觉模拟评分（VAS）。使用 RevMan V.5.3 软件进行荟萃分析。
纳入 9 项 RCT，共 572 例患者。当 WNA 作为常规药物辅助治疗时，荟萃分析显示腰椎 BMD 增加有统计学意义（均数差（MD）=0.06，95%置信区间（CI）0.03 至 0.08，P<0.001）。WNA 单独应用时可增加股骨颈（MD 0.14，95%CI 0.08 至 0.21，P<0.001）和大转子（MD 0.09，95%CI 0.04 至 0.15，P<0.001）的 BMD，联合常规药物应用时可降低 VAS 评分（MD=-1.10，95%CI-1.14 至-1.06，P<0.001）。然而，WNA 的安全性并未专门报道。
WNA 可能对原发性 OP 患者的 BMD 和 VAS 评分有有益影响。然而，所有纳入的试验均存在高偏倚风险和低质量。需要进一步的严格研究来确定 WNA 治疗原发性 OP 的疗效。
