针灸治疗非特异性下腰痛概况性综述

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

该研究通过概况性综述对针灸治疗非特异性下腰痛的随机对照试验(RCT)进行系统检索和梳理,展示研究证据现状,并为未来临床研究和医疗卫生决策提供参考依据。检索8个常用中、英文文献数据库,检索时间自建库至2023年7月7日,通过可视化分析当前研究的现状。共纳入文献50篇,其中中文23篇,英文27篇,文献量整体呈增长趋势。42.0%的文献发表于中文非核心期刊;关注的疾病分型以慢性非特异性下腰痛为主,占68.0%;样本量主要集中在50~100例。共归纳15种干预类型,以针刺干预的研究最多。80.0%的文献疗程不超过1个月,仅8.0%的文献使用最小临床重要差异(MCID)作为判断依据,28.0%的文献随访期设置在3个月内,82.0%的文献认为针灸治疗非特异性下腰痛有效;20.0%的文献报告了不良事件。纳入文献以低偏倚风险和偏倚风险不确定为主,高偏倚风险较少。在82.0%的文献中,针灸的治疗效果显著优于对照组。针灸治疗非特异性下腰痛发展迅速,但目前对于心理状态、安全性等指标研究不足,仍有部分研究偏倚风险不确定,不利于结果的推广应用,未来应继续改进完善。

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 acupuncturemoxibustion 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.