Xiangya Nursing School, Central South University, Changsha, China.
Department of Infectious Disease, Xiangya Hospital, Central South University, Changsha, China.
Acupunct Med. 2020 Aug;38(4):235-243. doi: 10.1136/acupmed-2017-011622. Epub 2020 May 27.
To assess the effectiveness of acupuncture for non-specific low back pain (NSLBP) through systematic review of published randomised controlled trials (RCTs).
Studies were identified in electronic databases from their inception to February 2018, and were grouped according to the control interventions. The outcomes of interest were pain intensity and disability. Methodological quality was evaluated using the Cochrane risk-of-bias criteria and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) checklist. The review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.
25 trials (n=7587 participants) were identified and included in a meta-analysis. The results showed that acupuncture was more effective at inducing pain relief than: no treatment (standardised mean difference (SMD) -0.69, 95% CI -0.99 to -0.38); sham acupuncture in the immediate term (SMD -0.33, 95% CI -0.49 to -0.18), short term (SMD -0.47, 95% CI -0.77 to -0.17), and intermediate term (SMD -0.17, 95% CI -0.28 to -0.05); and usual care in the short term (SMD -1.07, 95% CI -1.81 to -0.33) and intermediate term (SMD -0.43, 95% CI -0.77 to -0.10). Also, adjunctive acupuncture with usual care was more effective than usual care alone at all time points studied. With regard to functional improvement, the analysis showed a significant difference between acupuncture and no treatment (SMD -0.94, 95% CI -1.57 to -0.30), whereas the other control therapies could not be assessed.
We draw a cautious conclusion that acupuncture appears to be effective for NSLBP and that acupuncture may be an important supplement to usual care in the management of NSLBP.
通过对已发表的随机对照试验（RCT）进行系统评价，评估针灸治疗非特异性下腰痛（NSLBP）的疗效。
从研究开始到 2018 年 2 月，在电子数据库中检索研究，并根据对照干预措施进行分组。关注的结局指标为疼痛强度和残疾。使用 Cochrane 偏倚风险标准和针刺临床试验报告标准（STRICTA）检查表评估方法学质量。综述按照 PRISMA（系统评价和荟萃分析的首选报告项目）指南进行报告。
共确定 25 项试验（n=7587 名参与者）并纳入荟萃分析。结果表明，与：空白对照（标准化均数差（SMD）-0.69，95%置信区间（CI）-0.99 至 -0.38）；即时期假针刺（SMD-0.33，95%CI-0.49 至 -0.18）、短期（SMD-0.47，95%CI-0.77 至 -0.17）和中期（SMD-0.17，95%CI-0.28 至 -0.05）；以及短期（SMD-1.07，95%CI-1.81 至 -0.33）和中期（SMD-0.43，95%CI-0.77 至 -0.10）常规护理相比，针灸在减轻疼痛方面更有效。此外，辅助针灸加常规护理在所有研究时间点均优于常规护理。关于功能改善，分析显示针灸与空白对照之间存在显著差异（SMD-0.94，95%CI-1.57 至 -0.30），而其他对照疗法无法评估。
我们得出一个谨慎的结论，即针灸似乎对 NSLBP 有效，并且针灸可能是 NSLBP 常规治疗的重要补充。
