Huh Jeong Ho, Jeong Hye In, Kim Kyeong Han
College of Korean Medicine, Woosuk University, Jeonju, Republic of Korea.
Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
J Pharmacopuncture. 2021 Dec 31;24(4):153-164. doi: 10.3831/KPI.2021.24.4.153.
Despite the low cost and high accessibility of manual acupuncture (MA) treatments for the carpal tunnel syndrome (CTS), this intervention has not been uniformly evaluated in systematic reviews (SR), and no SR has evaluated MA monotherapy for CTS. This review was conducted to summarize the findings and undertake a quality assessment of randomized controlled trials (RCTs) of acupuncture treatment methods for mild-to-moderate CTS to identify clinical evidence for the use of MA in CTS.
We searched five databases for articles on relevant RCTs that were published until June 2021 without imposing specific restrictions, such as age or sex, on CTS patients. RCTs that evaluated MA were included without any restriction on comparator interventions. Measurement tools for evaluating pain reduction and functional improvement or for evaluating efficacy using electrophysiological indicators were included as outcome measures.
We included seven RCTs, of which three studies reported both post-treatment improvement effects and statistical significance using p-values for all outcomes. Five studies reported statistically significant intergroup differences (p-values for all outcomes) in post-treatment improvement. None of the studies reported severe adverse effects of MA. In all of the RCTs, the reporting rates of the 2c, 2a, and 6a items of STRICTA 2010 were 14%, 29%, and 29%, respectively. PC7 () was used to treat CTS in all of the included studies.
MA can be used for CTS treatment without serious adverse effects. PC7 was the most commonly used acupoint. In order to ensure objective and reliable reporting, accurate standardization of acupuncture treatment methods acupoint terms should be undertaken in future RCTs.
尽管腕管综合征(CTS)的手动针灸(MA)治疗成本低且可及性高,但该干预措施在系统评价(SR)中尚未得到统一评估,且尚无SR评估MA单药治疗CTS的效果。本综述旨在总结轻度至中度CTS针灸治疗方法的随机对照试验(RCT)结果并进行质量评估,以确定MA治疗CTS的临床证据。
我们检索了五个数据库,查找截至2021年6月发表的有关相关RCT的文章,对CTS患者没有施加年龄或性别等特定限制。纳入评估MA的RCT,对对照干预措施没有任何限制。将评估疼痛减轻和功能改善或使用电生理指标评估疗效的测量工具作为结局指标。
我们纳入了七项RCT,其中三项研究报告了所有结局的治疗后改善效果以及使用p值的统计学意义。五项研究报告了治疗后改善的组间差异具有统计学意义(所有结局的p值)。没有研究报告MA的严重不良反应。在所有RCT中,2010年STRICTA的2c、2a和6a项的报告率分别为14%、29%和29%。所有纳入研究均使用内关穴(PC7)治疗CTS。
MA可用于CTS治疗,且无严重不良反应。内关穴是最常用的穴位。为确保报告客观可靠,未来的RCT应准确规范针灸治疗方法和穴位术语。