Wang Yu-Ling, An Chun-Mei, Song Shan, Lei Feng-Ling, Wang Yin
Complement Med Res. 2018;25(4):249-255. doi: 10.1159/000488707. Epub 2018 Jul 16.
This systematic review was aimed to evaluate the efficacy and safety of cupping therapy for treating patients with knee osteoarthritis (KOA).
The following databases were searched from their inception until June 2017: the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and 4 Chinese databases (Wan Fang Data, Chinese Biomedical Literature Database (CBM), VeiPu, and China National Knowledge Infrastructure (CNKI)). Randomized controlled trials (RCTs) assessing the effects of cupping therapy on KOA were included in this systematic review. A quantitative synthesis of the RCTs was conducted using RevMan 5.3 software. Study selection and data extraction and validation were performed independently by 2 reviewers. Cochrane criteria for risk of bias were used to assess the methodological quality of the trials.
A total of 5 studies met our inclusion criteria. We analyzed the data from these 5 RCTs involving 535 participants. All included studies were judged to be at high risk for bias. Dry cupping therapy plus Western medicine therapy was more effective than Western therapy alone in reducing the pain scores (mean difference (MD) = -1.79, 95% confidence interval (CI) -2.40 to -1.18; p < 0.01). In addition, the study participants in the dry cupping therapy plus Western medicine therapy group showed significantly greater improvements in the pain (MD = -0.73, 95% CI -1.61 to -0.41; p < 0.01), stiffness (MD = -0.94, 95% CI -1.30 to -0.58; p < 0.01), and physical function (MD = -10.07, 95% CI -13.45 to -6.69; p < 0.01) domains of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to participants in the Western medicine therapy group. Moreover, when compared with Western medicine therapy alone, a meta-analysis of 4 RCTs suggested statistically significant favorable effects of wet cupping therapy plus Western medicine on the Lequesne Algofunctional Index (LAI) (MD = -3.44, 95% CI -4.21 to -2.68; p < 0.01).
There is weak evidence to support the hypothesis that cupping therapy has beneficial effects on reducing the pain intensity and improving the physical function in patients with KOA.
本系统评价旨在评估拔罐疗法治疗膝骨关节炎（KOA）患者的疗效和安全性。
检索以下数据库自建库至2017年6月的数据：Cochrane对照试验中心注册库、PubMed、EMBASE以及4个中文数据库（万方数据、中国生物医学文献数据库（CBM）、维普和中国知网（CNKI））。纳入评估拔罐疗法对KOA疗效的随机对照试验（RCT）进行本系统评价。使用RevMan 5.3软件对RCT进行定量合成。由2名评价员独立进行研究选择、数据提取及验证。采用Cochrane偏倚风险标准评估试验的方法学质量。
共有5项研究符合纳入标准。我们分析了这5项RCT涉及535名参与者的数据。所有纳入研究均被判定存在高偏倚风险。在降低疼痛评分方面，单纯火罐疗法联合西药治疗比单纯西药治疗更有效（平均差（MD）=-1.79，95%置信区间（CI）-2.40至-1.18；p<0.01）。此外，与西药治疗组相比，单纯火罐疗法联合西药治疗组的研究参与者在西安大略和麦克马斯特大学骨关节炎指数（WOMAC）的疼痛（MD=-0.73，95%CI -1.61至-0.41；p<0.01）、僵硬（MD=-0.94，95%CI -1.30至-0.58；p<0.01）和身体功能（MD=-10.07，95%CI -13.45至-6.69；p<0.01）领域有显著改善。此外，与单纯西药治疗相比，4项RCT的荟萃分析表明，水罐疗法联合西药对Lequesne功能指数（LAI）有统计学上显著的有利影响（MD=-3.44，95%CI -4.21至-2.68；p<0.01）。
仅有微弱证据支持拔罐疗法对减轻KOA患者疼痛强度和改善身体功能有有益作用这一假设。
