Asano Hitomi, Plonka Derek, Weeger Jacqueline
Emperor's College of Traditional Oriental Medicine, Santa Monica, CA, USA.
University of Southern California, Los Angeles, CA, USA.
Med Acupunct. 2022 Apr 1;34(2):96-106. doi: 10.1089/acu.2021.0057. Epub 2022 Apr 19.
This systematic review and meta-analysis assess the effectiveness of acupuncture as an adjunct to standard therapy in the management of nonspecific chronic low back pain (NScLBP), compared with standard therapy alone.
A systematic literature search of full-text articles of randomized controlled trials in the date range of 2000-2020, utilizing PubMed and EBSCO databases, was performed to evaluate the efficacy of acupuncture treatment for nonspecific chronic lower back pain. The outcomes of interest were pain intensity and disability. The methodological quality of each study was evaluated using Cochrane risk-of-bias criteria. The studies were combined using meta-analysis when statistical pooling of data was possible.
This systematic review included 5 studies of which 4 were included in the meta-analysis. Acupuncture as an adjunct to standard therapy had clinically meaningful reduction in self-reported pain at post-treatment (mean difference = -1.04 [95% confidence interval (CI), -1.59 to -0.49], < 0.001, = 46.1%) and at intermediate term (mean difference = -0.82 [95% CI, -1.13 to -0.50], < 0.001, = 0%), compared with standard care. Levels of disability showed similar clinically meaningful reduction at post-treatment and intermediate term.
Both the systematic review and meta-analysis demonstrate that acupuncture as an adjunct to standard therapy is a safe and effective method in reducing pain and disability among adults with NScLBP.
本系统评价和荟萃分析旨在评估与单纯标准治疗相比，针刺作为标准治疗辅助手段在非特异性慢性下腰痛（NScLBP）管理中的有效性。
利用PubMed和EBSCO数据库，对2000年至2020年期间随机对照试验的全文文章进行系统文献检索，以评估针刺治疗非特异性慢性下腰痛的疗效。感兴趣的结局指标为疼痛强度和功能障碍。使用Cochrane偏倚风险标准评估每项研究的方法学质量。当数据可进行统计合并时，采用荟萃分析对研究进行合并。
本系统评价纳入5项研究，其中4项纳入荟萃分析。与标准治疗相比，针刺作为标准治疗的辅助手段在治疗后（平均差值=-1.04[95%置信区间（CI），-1.59至-0.49]，P<0.001，I²=46.1%）和中期（平均差值=-0.82[95%CI，-1.13至-0.50]，P<0.001，I²=0%）自我报告的疼痛有临床意义的降低。功能障碍水平在治疗后和中期也显示出类似的有临床意义的降低。
系统评价和荟萃分析均表明，针刺作为标准治疗的辅助手段是一种安全有效的方法，可减轻NScLBP成人的疼痛和功能障碍。
