The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, GuangDong 518033, China.
College of Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China.
Pain Res Manag. 2020 Mar 20;2020:8506591. doi: 10.1155/2020/8506591. eCollection 2020.
This study aimed at assessing the clinical effectiveness of acupuncture for lateral epicondylitis (LE).
The following databases were systematically searched: China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wan Fang database, Chinese Biomedicine Literature, PubMed, EMBASE, and Cochrane Library from inception to May 2019. Randomized controlled trials (RCTs) meeting the inclusion criteria were included. RevMan 5.3 software was used to conduct meta-analyses. The study quality was evaluated with the Cochrane risk of bias.
Ten RCTs involving 796 individuals were included in this meta-analysis. Three studies reported randomized methods with a specific description. For the analyses of the clinical efficacy rate, acupuncture outperformed sham acupuncture (two RCTs, = 130, =0.15), medicine therapy (two RCTs, = 124, =0.02), and blocking therapy (four RCTs, = 427, =0.0001). For the analyses of the visual analog scale, acupuncture outperformed sham acupuncture (two RCTs, = 92, =0.18), medicine therapy (two RCTs, = 144, < 0.00001), and blocking therapy (two RCTs, = 132, =0.03). The subgroup analyses comparing acupuncture with sham acupuncture therapy revealed heterogeneities. The follow-up information and adverse reactions were not analyzed because of the insufficient number of studies.
Acupuncture appears to be superior to drug or blocking therapy or sham acupuncture therapy for LE. However, considering the low quality of the available trials, further large-scale RCTs with a low risk of bias are needed in the future.
本研究旨在评估针灸治疗外侧肱骨上髁炎（LE）的临床疗效。
系统检索了中国知网、中文科技期刊数据库、万方数据库、中国生物医学文献数据库、PubMed、EMBASE 和 Cochrane 图书馆自成立至 2019 年 5 月的文献。纳入符合纳入标准的随机对照试验（RCT）。使用 RevMan 5.3 软件进行荟萃分析。采用 Cochrane 偏倚风险评估研究质量。
本荟萃分析纳入了 10 项 RCT，共 796 名参与者。其中 3 项研究报告了随机方法并进行了具体描述。在临床疗效率分析中，针灸优于假针灸（2 项 RCT，=130，=0.15）、药物治疗（2 项 RCT，=124，=0.02）和阻滞治疗（4 项 RCT，=427，=0.0001）。在视觉模拟评分分析中，针灸优于假针灸（2 项 RCT，=92，=0.18）、药物治疗（2 项 RCT，=144，<0.00001）和阻滞治疗（2 项 RCT，=132，=0.03）。与假针灸治疗相比，针灸的亚组分析显示存在异质性。由于研究数量不足，未对随访信息和不良反应进行分析。
针灸治疗 LE 似乎优于药物或阻滞治疗或假针灸治疗。然而，考虑到现有试验的质量较低，未来需要进一步开展低偏倚风险的大规模 RCT。
