Anesthesiology and Pain Medicine, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Department of Nursing, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
J Manipulative Physiol Ther. 2021 Mar;44(3):255-270. doi: 10.1016/j.jmpt.2020.08.003. Epub 2021 Jan 9.
The purpose of this study was to review the literature on the effect of scraping therapy on chronic low back pain (LBP) from randomized controlled trials (RCTs).
Three English medical electronic databases (PubMed, Embase, and the Cochrane Library) and 2 Chinese databases (China National Knowledge Infrastructure and Wanfang) were searched. Only randomized controlled trials related to the effects of scraping therapy on chronic LBP were included in this systematic review. Study selection, data extraction, and validation were conducted independently by 2 reviewers. The methodological quality of the studies was evaluated by the Cochrane risk-of-bias tool. RevMan 5.3 software was applied to perform meta-analysis of the data.
Ten studies comprising 627 participants were included. Overall, the quality of evidence was moderate owing to a lack of blinding and allocation concealment in some studies and unclear risk of selective reporting. Meta-analysis of 9 RCTs indicated that scraping therapy had a statistically significant effect on pain reduction (standard mean difference = -0.66, 95% confidence interval [CI], -0.83 to -0.49, P < .001). However, if only a single scrape treatment was carried out, the results did not show that scraping was superior to the control group regarding pain relief (mean difference = -0.35, 95% CI, -1.23 to 0.53, P = .44). Moreover, the results of 6 RCTs involving 468 participants showed significantly greater improvement in lumbar dysfunction (mean difference = -10.05, 95% CI, -13.52 to -2.32, P < .001). In addition, the results of 5 RCTs involving 393 participants showed a favorably significant effect on the overall efficacy (odds ratio = 4.74, 95% CI, 2.34-9.62, P < .001). As for follow-up effects, meta-analysis of 3 RCTs involving 241 participants showed a promising effect on pain reduction and lumbar function improvement at 1 month and 3 months after the end of treatment, respectively. Only 1 study reported adverse effects, and none were serious.
Scraping therapy may have a therapeutic effect for some individuals with chronic LBP. However, due to the limited amount of research and the low methodological quality of the included studies, additional large-scale, multicenter, high-quality RCTs on relieving pain intensity and improving lumbar dysfunction are still necessary.
本研究旨在通过随机对照试验（RCT）回顾刮痧疗法治疗慢性下背痛（LBP）的文献。
检索了 3 个英文医学电子数据库（PubMed、Embase 和 Cochrane Library）和 2 个中文数据库（中国知网和万方）。本系统评价仅纳入了与刮痧疗法治疗慢性 LBP 效果相关的 RCT。由 2 位评审员独立进行研究选择、数据提取和验证。采用 Cochrane 偏倚风险工具评估研究的方法学质量。RevMan 5.3 软件用于对数据进行荟萃分析。
共纳入 10 项研究，包含 627 名参与者。由于部分研究缺乏盲法和分配隐藏，且选择性报告风险不明确，总体证据质量为中等。9 项 RCT 的荟萃分析表明，刮痧疗法在减轻疼痛方面具有统计学意义（标准均数差= -0.66，95%置信区间 [CI]，-0.83 至 -0.49，P<0.001）。然而，如果仅进行单次刮痧治疗，结果显示刮痧在缓解疼痛方面并不优于对照组（均数差= -0.35，95%CI，-1.23 至 0.53，P=0.44）。此外，6 项 RCT 涉及 468 名参与者的结果显示，腰椎功能障碍的改善明显更大（均数差= -10.05，95%CI，-13.52 至 -2.32，P<0.001）。此外，5 项 RCT 涉及 393 名参与者的结果显示，在整体疗效方面具有显著有利的影响（比值比=4.74，95%CI，2.34-9.62，P<0.001）。关于随访效果，3 项 RCT 涉及 241 名参与者的荟萃分析分别显示，在治疗结束后 1 个月和 3 个月时，刮痧疗法在减轻疼痛和改善腰椎功能方面具有有前景的效果。只有 1 项研究报告了不良反应，但均不严重。
刮痧疗法可能对某些慢性 LBP 患者具有治疗作用。然而，由于研究数量有限且纳入研究的方法学质量较低，仍需要开展更多关于减轻疼痛强度和改善腰椎功能的大型、多中心、高质量 RCT。
