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[针灸治疗非特异性下腰痛的范围综述]

[Scoping review of acupuncture-moxibustion treatment for non-specific low back pain].

作者信息

Shi Lan-Jun, Tian Zi-Yu, Wang Wen-Ya, Liao Xing

机构信息

Center for Evidence-based Chinese Medicine, Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences Beijing 100700, China.

Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences Beijing 100700, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2023 Dec;48(23):6249-6256. doi: 10.19540/j.cnki.cjcmm.20230915.502.

Abstract

This study systematically searched and sorted out randomized controlled trial(RCT) of acupuncture-moxibustion treatment for non-specific low back pain by scoping review, so as to demonstrate the current state of the research evidence and provide a reference point for future clinical research and healthcare decision-making. Eight commonly used Chinese and English databases were searched, and the search time was from the establishment of the databases to July 7, 2023, so as to analyze the characteristics of the current status of the current research through visualization methods. A total of 50 studies were included, including 23 studies in Chinese and 27 studies in English. The overall number of studies showed an increasing trend. The percentage of studies published in Chinese non-core journals was 42.0%. The disease subtypes of interest were mainly chronic non-specific low back pain, accounting for 68.0% of the studies. The sample sizes of the studies were mainly concentrated in the range of 50-100 cases. A total of 15 types of interventions were categorized, with acupuncture interventions being the most studied. Duration of treatment did not exceed one month in 80.0% of the studies. Only 8.0% of the studies used minimal clinical important difference(MCID) as a basis for judgment. The follow-up period was set within 3 months in 28.0% of the studies, and 82.0% of the studies concluded that acupuncture-moxibustion was effective in the treatment of non-specific lower back pain. Adverse events were reported in 20.0% of the studies. The risk of bias in the included studies was dominated by low risk of bias and uncertain risk of bias, with fewer studies focusing on high risks of bias. In most of the studies, acupuncture-moxibustion was significantly more effective than the control group. The research on acupuncture-moxibustion treatment for non-specific low back pain is developing rapidly, but there are still insufficient studies on psychological state, safety, and other indicators, and there are still some studies with uncertain risks of bias, which is not conducive to the generalization and application of the findings. Therefore, future studies should improve and refine these shortcomings.

摘要

本研究通过范围综述系统检索并梳理了针灸治疗非特异性下腰痛的随机对照试验(RCT),以展示研究证据的现状,为未来临床研究和医疗决策提供参考依据。检索了8个常用的中英文数据库,检索时间从数据库建立至2023年7月7日,以便通过可视化方法分析当前研究现状的特征。共纳入50项研究,其中中文研究23项,英文研究27项。研究总数呈上升趋势。发表于中文非核心期刊的研究占比为42.0%。感兴趣的疾病亚型主要为慢性非特异性下腰痛,占研究的68.0%。研究样本量主要集中在50 - 100例。共归纳出15种干预类型,其中针灸干预研究最多。80.0%的研究治疗时长不超过1个月。仅有8.0%的研究采用最小临床重要差异(MCID)作为判断依据。28.0%的研究随访期设定在3个月内,82.0%的研究得出针灸治疗非特异性下腰痛有效的结论。20.0%的研究报告了不良事件。纳入研究的偏倚风险以低偏倚风险和不确定偏倚风险为主,关注高偏倚风险的研究较少。在大多数研究中,针灸治疗显著优于对照组。针灸治疗非特异性下腰痛的研究发展迅速,但在心理状态、安全性等指标方面的研究仍不足,且仍有一些研究存在不确定的偏倚风险,不利于研究结果的推广应用。因此,未来研究应改进和完善这些不足。

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