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针刺治疗腰背肌筋膜炎疗效的Meta分析

Meta-analysis of the efficacy of acupuncture in the treatment of low back fasciitis.

作者信息

Geng Tao, Lin Die, Fu Benzhuo, Wang Huan, Wan Jiajie

机构信息

Department of Psychosomatic Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing 100053, China.

Department of Sports, Qinhuangdao Vocational and Technical College Qinhuangdao 066102, Hebei, China.

出版信息

Am J Transl Res. 2023 Aug 15;15(8):5486-5494. eCollection 2023.

Abstract

BACKGROUND

Acupuncture has unique advantages in the treatment of low back fasciitis and has been paid increasing attention. At present, many studies have summarized the efficacy of acupuncture and moxibustion in the treatment of low back fasciitis, but few have been summarized from the perspective of acupuncture alone.

AIM

To evaluate the clinical efficacy of acupuncture in the treatment of lumbodorsal fasciitis by meta-analysis.

METHODS

The randomized controlled trials (RCT) of acupuncture in the treatment of low back fasciitis were searched in Pubmed, Embase, and Cochrane Library from the data of establishment to July 2023. Two authors independently conducted document screening, data abstraction, and qualitative assessment. RevMan 5.3 software and Stata 17.0 software were used for data analysis. The quantitative data were represented by mean difference (MD). The qualitative data were represented by odds ratio (OR).

RESULTS

Finally, a total of 12 RCTs with a total sample size of 930 cases were included, of which 461 patients received simple acupuncture treatment (Group A) and 469 patients received non-simple acupuncture treatment (Group B). The results of the meta-analysis showed that: (1) Clinical total effective rate: The results of subgroup analysis showed that the clinical total effective rate of acupuncture was significantly higher than that of Western medicine [OR = 12.72, (2.26, 71.78), = 0.004]; the total effective rate of the traditional Chinese medicine therapy was significantly higher than that of acupuncture [OR = 0.35, 95% CI (0.19, 0.65), < 0.001]. (2) Score of the visual analog scale (VAS) after treatment: There was no significant difference in VAS score between Group A and Group B after treatment [MD = -0.22, 95% CI (-1.56, 1.12), = 0.75]. (3) Oswestry disability index after treatment: The results of subgroup analysis showed that the Oswestry disability index after treatment of acupuncture was significantly lower than that of Western medicine therapy [MD = -0.05, (-0.10, -0.00), = 0.04]; the Oswestry disability index of Chinese medicine therapy was significantly lower than that of acupuncture alone [WD = 0.10, 95% CI (0.05, 0.15), < 0.001].

CONCLUSION

In the treatment of low back fasciitis, simple acupuncture therapy is superior to Western medicine therapy in improving treatment efficiency and low back muscle dysfunction, but slightly inferior to other traditional Chinese medicine therapies. Due to the limited efficacy of acupuncture, it is recommended to combine other therapies to improve the efficacy. Due to the small number of RTCs included and the unclear evaluation of many bias risks, high-quality, large sample randomized controlled studies are still needed to prove it.

摘要

背景

针灸在治疗腰背肌筋膜炎方面具有独特优势,受到越来越多的关注。目前,许多研究总结了针灸治疗腰背肌筋膜炎的疗效,但从单纯针灸角度进行总结的较少。

目的

通过Meta分析评价针灸治疗腰背肌筋膜炎的临床疗效。

方法

检索Pubmed、Embase和Cochrane图书馆中自建库至2023年7月针灸治疗腰背肌筋膜炎的随机对照试验(RCT)。由两位作者独立进行文献筛选、数据提取和定性评估。采用RevMan 5.3软件和Stata 17.0软件进行数据分析。定量数据以均数差(MD)表示。定性数据以比值比(OR)表示。

结果

最终纳入12项RCT,共930例,其中461例接受单纯针灸治疗(A组),469例接受非单纯针灸治疗(B组)。Meta分析结果显示:(1)临床总有效率:亚组分析结果显示,针灸的临床总有效率显著高于西药[OR = 12.72,95%CI(2.26,71.78),P = 0.004];中医治疗的总有效率显著高于针灸[OR = 0.35,95%CI(0.19,0.65),P < 0.001]。(2)治疗后视觉模拟量表(VAS)评分:治疗后A组和B组VAS评分差异无统计学意义[MD = -0.22,95%CI(-1.56,1.12),P = 0.75]。(3)治疗后Oswestry功能障碍指数:亚组分析结果显示,针灸治疗后的Oswestry功能障碍指数显著低于西药治疗[MD = -0.05,95%CI(-0.10,-0.00),P = 0.04];中医治疗的Oswestry功能障碍指数显著低于单纯针灸[MD = 0.10,95%CI(0.05,0.15),P < 0.001]。

结论

在治疗腰背肌筋膜炎方面,单纯针灸疗法在提高治疗效率和改善腰背肌功能障碍方面优于西药疗法,但略逊于其他中医疗法。由于针灸疗效有限,建议联合其他疗法提高疗效。由于纳入的RTC数量较少,且对许多偏倚风险评估不明确,仍需要高质量、大样本的随机对照研究来证实。

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