推拿或针灸联合辅助疗法治疗神经根型颈椎病的网状Meta分析

Network meta-analysis of tuina or acupuncture in combination with adjunctive therapy for cervical spondylotic radiculopathy.

作者信息

Zhao Shengxiang, Yang Jie

机构信息

School of Acupuncture and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

Cardiovascular Surgery Department, Tianjin Chest Hospital, Tianjin, China.

出版信息

Front Neurol. 2025 Aug 8;16:1612024. doi: 10.3389/fneur.2025.1612024. eCollection 2025.

DOI:10.3389/fneur.2025.1612024

PMID:40860976

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12370718/

Abstract

BACKGROUND

Tuina and acupuncture therapy have been widely applied in patients with cervical spondylotic radiculopathy (CSR). This network meta-analysis (NMA) was carried out to compare the effects of tuina or acupuncture in combination with adjunctive therapy on the physical signs, symptoms, and clinical outcomes of patients with CSR.

METHOD

Relevant studies were searched in PubMed, Web of Science, Embase, Cochrane, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Data, and China Biology Medicine (CBM), up to June 15, 2023. Randomized controlled trials (RCTs) comparing tuina, acupuncture, or their combination with conventional Western medical adjunctive therapies were selected. Literature quality was assessed using the ROB2 tool, and statistical analyses were conducted using Stata SE15 and R 4.3.1.

RESULTS

90 studies involving 8,612 participants were included. Compared to acupuncture alone, acupuncture + warm needle acupuncture (RR: 17.97; 95% CrI [1.98, 563.78]), acupuncture + cupping (RR: 15.84; 95% CrI [1.48, 538.41]), tuina + auricular acupuncture and conventional therapy (RR: 12.83; 95%CrI [1.31, 170.78]), acupuncture + moxibustion (RR: 8.55; 95% CrI [2.17, 40.28]), and acupuncture + warm needle acupuncture (RR: 8.62; 95% CrI [1.78, 50.25]) significantly improved the clinical response rate, with acupuncture + warm needle acupuncture exhibiting the best effect (SUCRA: 85.9%). Tuina (SUCRA: 75%) ranked highest in improving the cervical function of patients. Electroacupuncture + moxibustion and conventional therapy (SUCRA: 97%) was most effective in relieving pain. None of these therapies effectively improved patient physical signs.

CONCLUSION

Needling + warm needle acupuncture, warm needle acupuncture + auricular acupuncture, and warm needle acupuncture + conventional therapy may better alleviate symptoms in patients with CSR. However, more well-designed multicenter, large-sample RCTs are needed to further analyze the findings from this study.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/view/CRD42023443945, CRD42023443945.

摘要

背景

推拿和针灸疗法已广泛应用于神经根型颈椎病（CSR）患者。本网络荟萃分析（NMA）旨在比较推拿或针灸联合辅助治疗对CSR患者体征、症状及临床结局的影响。

方法

在PubMed、Web of Science、Embase、Cochrane、中国知网（CNKI）、维普中文科技期刊数据库（VIP）、万方数据和中国生物医学文献数据库（CBM）中检索截至2023年6月15日的相关研究。选择比较推拿、针灸或其联合传统西医辅助疗法的随机对照试验（RCT）。使用ROB2工具评估文献质量，并使用Stata SE15和R 4.3.1进行统计分析。

结果

纳入90项研究，共8612名参与者。与单纯针灸相比，针灸 + 温针（RR：17.97；95% CrI [1.98，563.78]）、针灸 + 拔罐（RR：15.84；95% CrI [1.48，538.41]）、推拿 + 耳针及传统疗法（RR：12.83；95% CrI [1.31，170.78]）、针灸 + 艾灸（RR：8.55；95% CrI [2.17，40.28]）以及针灸 + 温针（RR：8.62；95% CrI [1.78，50.25]）显著提高了临床有效率，其中针灸 + 温针效果最佳（SUCRA：85.9%）。推拿在改善患者颈椎功能方面排名最高（SUCRA：75%）。电针 + 艾灸及传统疗法在缓解疼痛方面最有效（SUCRA：97%）。这些疗法均未有效改善患者的体征。