Wei Wei, Qin Yeyu, Lin Jie
Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, Hainan, 572023, People's Republic of China.
Department of Pharmacy, Hainan General Hospital, Haikou, Hainan, 570311, People's Republic of China.
J Pain Res. 2025 Jun 21;18:3087-3099. doi: 10.2147/JPR.S502457. eCollection 2025.
Given the prevalence of osteoarthritis and the growing interest in alternative treatments, there is a need to provide a comprehensive evaluation of this integrated TCM approach. Reviews are required to understand the potential benefits and safety of the combination therapy compared to conventional treatments. Hence, this meta-analysis investigates the effectiveness of combining Thunder Fire Moxibustion with other Traditional Chinese Medicine (TCM) modalities, specifically acupuncture and herbal formulas, in treating knee osteoarthritis.
A comprehensive literature search across databases like PubMed Central, EMBASE, MEDLINE, and others was conducted. The inclusion criteria focused on randomized controlled trials involving patients with knee osteoarthritis, comparing the effectiveness of Thunder Fire Moxibustion combined with other TCM modalities against standard care. The Cochrane Risk of Bias tool was used for bias assessment, and a random-effects inverse-variance model for meta-analysis.
Out of 1467 records, 7 studies met the inclusion criteria. The pooled Risk Ratio (RR) for total effective rate was 1.119, indicating a significant effect of the combined TCM treatment. Subgroup analysis showed a pooled RR of 1.130 for acupuncture combinations and 1.103 for herbal TCM combinations. The incidence of adverse reactions had a non-significant pooled RR of 0.572. The GRADE assessment indicated a low overall quality of evidence due to risks of bias and publication bias.
The combination of Thunder Fire Moxibustion with other TCM modalities shows potential effectiveness in treating knee osteoarthritis, with minimal adverse reactions. However, the low quality of evidence suggests a need for more rigorous studies to confirm these findings.
鉴于骨关节炎的患病率以及对替代疗法的兴趣日益增加，有必要对这种中医综合疗法进行全面评估。需要通过综述来了解联合疗法与传统疗法相比的潜在益处和安全性。因此，本荟萃分析调查了雷火灸与其他中医方法（特别是针灸和中药方剂）联合治疗膝骨关节炎的有效性。
对PubMed Central、EMBASE、MEDLINE等数据库进行了全面的文献检索。纳入标准侧重于涉及膝骨关节炎患者的随机对照试验，比较雷火灸联合其他中医方法与标准护理的有效性。采用Cochrane偏倚风险工具进行偏倚评估，并使用随机效应逆方差模型进行荟萃分析。
在1467条记录中，有7项研究符合纳入标准。总有效率的合并风险比（RR）为1.119，表明中医联合治疗有显著效果。亚组分析显示，针灸联合治疗的合并RR为1.130，中药联合治疗的合并RR为1.103。不良反应发生率的合并RR为0.572，无显著意义。GRADE评估表明，由于存在偏倚风险和发表偏倚，证据的总体质量较低。
雷火灸与其他中医方法联合应用在治疗膝骨关节炎方面显示出潜在的有效性，不良反应最小。然而，证据质量较低表明需要进行更严格的研究来证实这些发现。
