Trinh Kien, Belski Nikita, Zhou Fangwen, Kuhad Arul, Luk David, Youn Eunjae
Michael G. Degroote School of Medicine, McMaster University, Hamilton, Canada.
Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada.
Med Acupunct. 2021 Dec 1;33(6):386-395. doi: 10.1089/acu.2021.0006. Epub 2021 Dec 16.
To assess the effect of acupuncture on foot and ankle pain intensity, functional status, quality of life, and incidence of adverse events in adults. Randomized controlled trials (RCTs) were obtained from a systematic search of 6 major English databases, and a manual search of relevant systematic reviews using Google Scholar. RCTs that compared acupuncture with various forms of sham acupuncture, nonactive and waitlist controls for pain intensity, functional status, and general quality of life were included. Study screening, data extraction, risk of bias assessment, and quality assessment were all performed independently. A narrative synthesis was performed when quantitative pooling was inappropriate. Four RCTs were included, encompassing a total of 211 participants. Due to clinical heterogeneity for all outcomes, quantitative analysis was not appropriate. Our Grades of Recommendation, Assessment, Development and Evaluation rated all outcomes to have either low or very low quality of evidence. With low-quality evidence, acupuncture was shown to be efficacious for participants with plantar fasciitis for pain relief and functional status improvement at short- and intermediate-term follow-ups. Acupuncture was also shown to be efficacious for participants with Achilles tendinopathy for pain relief at short- and intermediate-term follow-ups. No adverse events were reported. There is some evidence to suggest acupuncture to be a safe and efficacious treatment for relieving pain and improving functional status for the foot and ankle. The results of this systematic review should be interpreted with caution due to the limited evidence. Future research should take into consideration the findings of this systematic review.
评估针刺疗法对成人足踝疼痛强度、功能状态、生活质量及不良事件发生率的影响。通过系统检索6个主要英文数据库获取随机对照试验（RCT），并使用谷歌学术手动检索相关系统评价。纳入比较针刺疗法与各种形式假针刺、非活性对照和等待列表对照在疼痛强度、功能状态及总体生活质量方面效果的RCT。研究筛选、数据提取、偏倚风险评估和质量评估均独立进行。当定量合并不合适时进行叙述性综合分析。共纳入4项RCT，涉及211名参与者。由于所有结局存在临床异质性，不适合进行定量分析。我们的推荐分级、评估、制定与评价（GRADE）对所有结局的证据质量评定为低或极低。基于低质量证据，针刺疗法对足底筋膜炎参与者在短期和中期随访时缓解疼痛及改善功能状态有效。针刺疗法对跟腱病参与者在短期和中期随访时缓解疼痛也有效。未报告不良事件。有证据表明针刺疗法是一种安全有效的治疗方法，可缓解足踝疼痛并改善功能状态。由于证据有限，本系统评价结果应谨慎解读。未来研究应考虑本系统评价的结果。
