Shaanxi University of Traditional Chinese Medicine, College of Acupuncture, Moxibustion and Tuina, Xianyang 712046, China.
Department of Acupuncture and Moxibustion, Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi'an 710003, China.
J Tradit Chin Med. 2022 Dec;42(6):869-876. doi: 10.19852/j.cnki.jtcm.20220922.003.
To systematically evaluate the efficacy and safety of blood pricking and cupping in the treatment of nonspecific low back pain (NLBP).
The China National Knowledge Infrastructure Database (CNKI), Wanfang Med Online Database (Wanfang), China Science and Technology Journal Database (VIP), PubMed, Web of Science, EMBase, and Cochrane Library databases were searched from inception to October 31, 2021, for randomized controlled trials (RCTs) of the treatment of NLBP by blood pricking and cupping. The quality of each included study was evaluated according to the Cochrane Systematic Assessor's Manual evaluation criteria, while the Meta-analysis was performed using RevMan 5.4 software.
A total of 13 thirteen RCTs included a total of 1088 subjects. The visual analogue scale scores indicated that blood pricking and cupping was superior to the other treatments at relieving NLBP pain [mean difference () = -1.43; 95% confidence interval (): -2.31 to 0.54; = 3.15; = 0.002). The Oswestry Disability Index score of blood pricking and cupping was superior to that of the control group in terms of improving NLBP dysfunction ( = -6.25; 95%: -8.37 to -4.31); = 5.77; < 0.000 01). 7 RCTs mentioned no adverse reactions, while one study reported mild syncope [7% (3), all in the 17-30 years group] that was gradually relieved after rest.
Blood pricking and cupping therapy can safely and effectively reduce pain and improve functional impairment in patients with NLBP. However, this study included limited high-grade studies with a small overall sample size; therefore, further high-quality large-sample RCTs are needed to improve clinical evidence.
系统评价刺络拔罐治疗非特异性下腰痛（NLBP）的疗效和安全性。
计算机检索中国知网（CNKI）、万方医学网（Wanfang）、维普网（VIP）、PubMed、Web of Science、EMBase、Cochrane 图书馆，搜集刺络拔罐治疗 NLBP 的随机对照试验（RCT），检索时限均为建库至 2021 年 10 月 31 日。根据 Cochrane 系统评价员手册评价标准评价纳入研究的质量，采用 RevMan 5.4 软件进行 Meta 分析。
共纳入 13 项 RCT，包括 1088 例患者。视觉模拟评分法（VAS）结果显示，刺络拔罐缓解 NLBP 疼痛的疗效优于其他治疗措施[均数差（MD）=-1.43，95%置信区间（CI）：-2.31 至 0.54；= 3.15；= 0.002]。Oswestry 功能障碍指数（ODI）评分结果显示，刺络拔罐改善 NLBP 功能障碍的疗效优于对照组[MD=-6.25，95%CI：-8.37 至-4.31；= 5.77；< 0.000 01]。7 项 RCT 未提及不良反应，1 项 RCT 报道 1 例轻度晕厥[7%（3/42），均发生在 17~30 岁年龄组]，休息后可逐渐缓解。
刺络拔罐治疗可安全、有效地减轻 NLBP 患者的疼痛，改善其功能障碍，但本研究纳入的高质量研究较少，且总体样本量较小，需开展更多高质量、大样本 RCT 以提高临床证据等级。
