腕踝针治疗腰痛的Meta分析

Wrist and ankle acupuncture for low back pain:a Meta-analysis

目的:评价腕踝针治疗腰痛的临床疗效和安全性。方法:检索中英文数据库,包括PubMed、EMbase、the Cochrane Library、万方数据库、中国知网、维普数据库和中国生物医学文献数据库等有关腕踝针治疗腰痛的随机对照试验,检索时间为各数据库建库至2021年4月。2名研究人员独立阅读和筛选文献、提取资料、对文献进行偏倚风险评价,采用RevMan 5.3统计软件进行Meta分析。结果:最终纳入18篇随机对照试验研究,涉及1927例病人。Meta分析结果显示,在临床总有效率方面单用腕踝针或腕踝针联合其他疗法治疗优于其他疗法[RR=1.12,95%CI(1.07,1.18),P<0.00001];单用腕踝针与西药比较,无统计学意义[RR=1.06,95%CI(0.91,1.22),P=0.46];腕踝针联合其他针法优于单用其他针法[RR=1.15,95%CI(1.08,1.22),P<0.0001]。在VAS评分方面,单用腕踝针或腕踝针联合其他疗法其优于疗法[MD=-0.75,95%CI(-1.47,-0.04),P=0.04];单用腕踝针与使用西药比较,差异无统计学意义[MD=-0.81,95%CI(-1.96,0.35),P=0.17];腕踝针联合其他针法与其他针法比较,差异无统计学意义[MD=-0.17,95%CI(-1.36,1.02),P=0.78]。结论:现有证据表明,在常规治疗的基础上,联合腕踝针能安全、有效缓解病人腰痛。

Objective:To evaluate the clinical efficacy and safety of wrist and ankle acupuncture for low back pain.Methods:Randomized controlled trials of wrist and ankle acupuncture for low back pain were retrieved from Chinese and English databases including PubMed,EMbase,the Cochrane Library,WanFang Database,CNKI,VIP and CBM.The retrieval time was limited to the establishment of each database until April 2021.Reading and screening the literature,extracting data,and evaluating the risk of bias of the literature were independently conducted by two researchers,and the statistical software RevMan 5.3 was used for Meta-analysis.Results:A total of 18 randomized controlled trials involving 1927 patients were included.Meta-analysis results showed that,in terms of total clinical efficacy,wrist and ankle acupuncture alone or wrist and ankle acupuncture combined with other therapies was superior to other therapies[RR=1.12,95%CI(1.07,1.18),P<0.00001];there was no significant difference between wrist and ankle acupuncture alone and western medicine[RR=1.06,95%CI(0.91,1.22),P=0.46];wrist and ankle needle combined with other acupuncture was better than other acupuncture[RR=1.15,95%CI(1.08,1.22),P<0.0001].In terms of VAS score,wrist and ankle acupuncture alone or wrist and ankle acupuncture combined with other treatments was better than other treatments[MD=-0.75,95%CI(-1.47,-0.04),P=0.04];there was no significant difference between wrist and ankle acupuncture alone and western medicine[MD=-0.81,95%CI(-1.96,0.35),P=0.17];there was no significant difference between wrist and ankle acupuncture combined with other acupuncture methods and other acupuncture methods[MD=-0.17,95%CI(-1.36,1.02),P=0.78].Conclusion:Existing evidence shows that,on the basis of conventional treatment,combined with wrist and ankle acupuncture can safely and effectively relieve low back pain in patients.