Su Xuan, Qian Hong, Chen Biyu, Fan Wenjuan, Xu Danghan, Tang Chunzhi, Lu Liming
Guangdong Provincial Hospital of Traditional Chinese Medicine Integrated with Western Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China.
Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.
Ann Palliat Med. 2021 Apr;10(4):3924-3936. doi: 10.21037/apm-20-1998. Epub 2021 Apr 8.
Acupuncture has been widely used for acute low back pain (LBP), yet there remains continued controversy regarding its efficacy. Therefore, we aimed to critically evaluate the evidence for acupuncture as an effective treatment for acute LBP.
English and Chinese databases were searched for randomized controlled trials (RCTs) that involved acupuncture for acute LBP published up to May 2020. Data on the outcomes of pain intensity, functional status, and analgesic use were extracted. The meta-analysis was performed using the Cochrane Collaboration's RevMan 5.3, and pooled data were expressed as mean differences (MD) with 95% confidence intervals (CIs).
Of the 13 eligible RCTs identified, 11 RCTs (involving 707 patients) provided moderate-quality evidence that acupuncture has a statistically significant association with improvements in VAS (visual analog scale) score [MD: -1.75 (95% CI: -2.39, -1.12)]. Two studies indicated that acupuncture did not influence the RMDQ (Roland-Morris Disability Questionnaire) scores more than the control treatment [MD: -2.34 (95% CI: -5.34, 0.67)]. Three studies suggested that acupuncture influenced the ODI (Oswestry Disability Index) scores more than the control treatment [MD: -12.84 (95% CI: -23.94, -1.74)]. Two studies suggested that acupuncture influenced the number of pills more than the control treatment [MD: -3.19 (95% CI: -3.45, -2.92)].
Acupuncture treatment of acute LBP was associated with modest improvements in the VAS score, ODI score, and the number of pills, but not the RMDQ score. Our findings should be considered with caution due to the low power original studies. High-quality trials are needed to assess further the role of acupuncture in the treatment of acute LBP.
针灸已被广泛用于治疗急性腰痛（LBP），但其疗效仍存在争议。因此，我们旨在严格评估针灸作为急性LBP有效治疗方法的证据。
检索英文和中文数据库，查找截至2020年5月发表的涉及针灸治疗急性LBP的随机对照试验（RCT）。提取疼痛强度、功能状态和镇痛药物使用结果的数据。使用Cochrane协作网的RevMan 5.3进行荟萃分析，汇总数据以平均差（MD）和95%置信区间（CI）表示。
在确定的13项合格RCT中，11项RCT（涉及707例患者）提供了中等质量的证据，表明针灸与视觉模拟量表（VAS）评分改善具有统计学显著关联[MD：-1.75（95%CI：-2.39，-1.12）]。两项研究表明，与对照治疗相比，针灸对罗兰·莫里斯残疾问卷（RMDQ）评分的影响不大[MD：-2.34（95%CI：-5.34，0.67）]。三项研究表明，与对照治疗相比，针灸对奥斯维斯特里残疾指数（ODI）评分的影响更大[MD：-12.84（95%CI：-23.94，-1.74）]。两项研究表明，与对照治疗相比，针灸对药物片数的影响更大[MD：-3.19（95%CI：-3.45，-2.92）]。
针灸治疗急性LBP与VAS评分、ODI评分及药物片数的适度改善相关，但与RMDQ评分无关。由于原始研究的效能较低，我们的研究结果应谨慎看待。需要高质量的试验来进一步评估针灸在急性LBP治疗中的作用。
