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针灸能改善慢性脊柱疼痛吗?一项系统评价与荟萃分析。

Can Acupuncture Improve Chronic Spinal Pain? A Systematic Review and Meta-Analysis.

作者信息

Huang Jin-Feng, Zheng Xuan-Qi, Chen Dong, Lin Jia-Liang, Zhou Wen-Xian, Wang Hui, Qin Zongshi, Wu Ai-Min

机构信息

Orthopaedic Hospital, 26453The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

25809The University of Hong Kong, Hong Kong, China.

出版信息

Global Spine J. 2021 Oct;11(8):1248-1265. doi: 10.1177/2192568220962440. Epub 2020 Oct 9.

Abstract

STUDY DESIGN

Systematic review and meta-analysis.

OBJECTIVE

To investigate the effect and safety of acupuncture for the treatment of chronic spinal pain.

METHODS

MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, the WHO Clinical Trial Registry, and the US National Library of Medicine clinical trial registry were searched from January 1, 2000, to November 1, 2019. Randomized controlled trials (RCTs) involving patients with chronic spinal pain treated by acupuncture versus sham acupuncture, no treatment, or another treatment were included.

RESULTS

Data was extracted from 22 RCTs including 2588 patients. Pooled analysis revealed that acupuncture can reduce chronic spinal pain compared to sham acupuncture (weighted mean difference [WMD] -12.05, 95% confidence interval [CI] -15.86 to -8.24), mediation control (WMD -18.27, 95% CI -28.18 to -8.37), usual care control (WMD -9.57, 95% CI -13.48 to -9.44), and no treatment control (WMD -17.10, 95% CI -24.83 to -9.37). In terms of functional disability, acupuncture can improve physical function at immediate-term follow-up (standardized mean difference [SMD] -1.74, 95% CI -2.04 to -1.44), short-term follow-up (SMD -0.89, 95% CI -1.15 to -0.62), and long-term follow-up (SMD -1.25, 95% CI -1.48 to -1.03).

CONCLUSION

In summary, compared to no treatment, sham acupuncture, or conventional therapy such as medication, massage, and physical exercise, acupuncture has a significantly superior effect on the reduction in chronic spinal pain and function improvement. Acupuncture might be an effective treatment for patients with chronic spinal pain and it is a safe therapy.

摘要

研究设计

系统评价与荟萃分析。

目的

探讨针刺治疗慢性脊柱疼痛的疗效及安全性。

方法

检索2000年1月1日至2019年11月1日期间的MEDLINE、EMBASE、Cochrane对照试验中心注册库(CENTRAL)、科学网、世界卫生组织临床试验注册库和美国国立医学图书馆临床试验注册库。纳入针刺与假针刺、不治疗或其他治疗相比治疗慢性脊柱疼痛患者的随机对照试验(RCT)。

结果

从22项RCT中提取数据,共纳入2588例患者。汇总分析显示,与假针刺(加权均数差[WMD] -12.05,95%置信区间[CI] -15.8,6至-8.24)、中介对照(WMD -18.27,95% CI -28.18至-8.37)、常规护理对照(WMD -9.57,95% CI -13.48至-9.44)和不治疗对照(WMD -17.10,95% CI -24.83至-9.37)相比,针刺可减轻慢性脊柱疼痛。在功能障碍方面,针刺可在近期随访(标准化均数差[SMD] -1.74, 95% CI -2.04至-1.44)、短期随访(SMD -0.89, 95% CI -I.15至-0.62)和长期随访(SMD -1.25, 95% CI -1.48至-1.03)时改善身体功能。

结论

总之,与不治疗、假针刺或药物、按摩和体育锻炼等传统疗法相比,针刺在减轻慢性脊柱疼痛和改善功能方面具有显著优势。针刺可能是慢性脊柱疼痛患者的一种有效治疗方法,且是一种安全的疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd66/8453671/2fa81cfcbc00/10.1177_2192568220962440-fig1.jpg

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