Chen Shun, Liu Weiting, Liang Changhao, Liu Hanjiang, Wang Pei, Fu Qinwei
The First School of Clinical Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China; The Second People's Hospital Affiliated to Fujian University of Chinese Medicine, Fuzhou, 350001, China.
School of Nursing and Midwifery, Edith Cowan University, Perth, 6027, Australia.
Complement Ther Clin Pract. 2025 May;59:101979. doi: 10.1016/j.ctcp.2025.101979. Epub 2025 Mar 28.
Although several reviews have examined moxibustion for knee osteoarthritis (KOA), they have some methodological limitations. This systematic review aims to synthesize current evidence on various moxibustion interventions for KOA pain relief.
We conducted a comprehensive search across seven databases up to June 2024. The Cochrane risk of bias tool (ROB2) was used to assess the risk of bias, and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criterion approach was employed to evaluate the certainty of evidence for primary outcomes. Primary outcomes included Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), stiffness, physical function, and total effective rate. Secondary outcomes encompassed adverse events (AEs) and treatment regimen of moxibustion for KOA. Meta-analysis was performed using STATA 17.0 and RevMan 5.4.1.
A total of 43 studies with 4008 participants were included in this review. Moxibustion significantly reduced WOMAC (-0.91, 95 % CI: -1.12, -0.70) and VAS scores (-0.95, 95 % CI: -1.18, -0.73). Electronic moxibustion was the most effective intervention. Treatment frequencies exceeding three times per week were more effective than fewer sessions. The total effective rate was 93.11 % for the moxibustion group versus 76.41 % for the controls. AEs were reported in sixteen studies, with one serious AE.
Moxibustion is more effective for pain relief than other treatments and has a lower incidence of AEs. Further high-level evidence is warranted to validate these findings.
尽管已有多项综述探讨了艾灸治疗膝骨关节炎（KOA）的疗效，但这些综述存在一些方法学上的局限性。本系统综述旨在综合当前有关各种艾灸干预措施缓解KOA疼痛的证据。
截至2024年6月，我们在七个数据库中进行了全面检索。采用Cochrane偏倚风险工具（ROB2）评估偏倚风险，并运用推荐分级、评估、制定与评价（GRADE）标准方法评估主要结局的证据确定性。主要结局包括视觉模拟评分法（VAS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、僵硬程度、身体功能及总有效率。次要结局包括不良事件（AE）以及KOA艾灸治疗方案。使用STATA 17.0和RevMan 5.4.1进行荟萃分析。
本综述共纳入43项研究，涉及4008名参与者。艾灸显著降低了WOMAC评分（-0.91，95%CI：-1.12，-0.70）和VAS评分（-0.95，95%CI：-1.18，-0.73）。电子艾灸是最有效的干预措施。每周治疗频率超过三次比治疗次数较少更有效。艾灸组的总有效率为93.11%，而对照组为76.41%。16项研究报告了不良事件，其中有1例严重不良事件。
艾灸在缓解疼痛方面比其他治疗方法更有效，且不良事件发生率较低。需要进一步的高级别证据来验证这些发现。
