Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
J Pain. 2020 Sep-Oct;21(9-10):943-956. doi: 10.1016/j.jpain.2020.01.002. Epub 2020 Jan 23.
There is a growing interest in nonpharmacological pain treatment options such as cupping. This meta-analysis aimed to assess the effectiveness and safety of cupping in chronic pain. PubMed, Cochrane Library, and Scopus were searched through November 2018 for randomized controlled trials on effects of cupping on pain intensity and disability in patients with chronic pain. Risk of bias was assessed using the Cochrane risk of bias tool. Of the 18 included trials (n =1,172), most were limited by clinical heterogeneity and risk of bias. Meta-analyses found large short-term effects of cupping on pain intensity compared to no treatment (standardized mean difference [SMD] = -1.03; 95% confidence interval [CI] = -1.41, -.65), but no significant effects compared to sham cupping (SDM = -.27; 95% CI = -.58, .05) or other active treatment (SMD = -.24; 95% CI = -.57, .09). For disability, there were medium-sized short-term effects of cupping compared to no treatment (SMD = -.66; 95% CI = -.99, -.34), and compared to other active treatments (SMD = -.52; 95% CI = -1.03, -.0028), but not compared to sham cupping (SMD = -.26; 95% CI = -.57,.05). Adverse events were more frequent among patients treated with cupping compared to no treatment; differences compared to sham cupping or other active treatment were not statistically significant. Cupping might be a treatment option for chronic pain, but the evidence is still limited by the clinical heterogeneity and risk of bias. Perspective: This article presents the results of a meta-analysis aimed to assess the effectiveness and safety of cupping with chronic pain. The results suggest that cupping might be a treatment option; however, the evidence is still limited due to methodical limitations of the included trials. High-quality trials seem warranted.
人们对非药物性疼痛治疗方法（如拔罐）越来越感兴趣。本荟萃分析旨在评估拔罐治疗慢性疼痛的疗效和安全性。检索了 PubMed、Cochrane 图书馆和 Scopus，以获取截至 2018 年 11 月有关拔罐对慢性疼痛患者疼痛强度和残疾影响的随机对照试验。使用 Cochrane 偏倚风险工具评估了偏倚风险。在纳入的 18 项试验（n=1172）中，大多数试验受到临床异质性和偏倚风险的限制。荟萃分析发现，与无治疗相比，拔罐在短期时间内对疼痛强度有较大的影响（标准化均数差 [SMD] =-1.03；95%置信区间 [CI] =-1.41，-.65），但与 sham-cupping （SMD =-.27；95% CI =-.58，.05）或其他活性治疗（SMD =-.24；95% CI =-.57，.09）相比，无显著影响。对于残疾，与无治疗相比，拔罐在短期时间内有中度影响（SMD =-.66；95% CI =-.99，-.34），与其他活性治疗相比（SMD =-.52；95% CI =-1.03，-.0028），但与 sham-cupping 相比无显著影响（SMD =-.26；95% CI =-.57，.05）。与无治疗相比，接受拔罐治疗的患者更常出现不良反应；与 sham-cupping 或其他活性治疗相比，差异无统计学意义。拔罐可能是治疗慢性疼痛的一种选择，但由于纳入试验的方法学局限性，证据仍然有限。需要高质量的试验。观点：本文介绍了一项旨在评估拔罐治疗慢性疼痛的疗效和安全性的荟萃分析结果。结果表明，拔罐可能是一种治疗选择；然而，由于纳入试验的方法学局限性，证据仍然有限。似乎需要进行高质量的试验。
