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Efficacy and safety of acupuncture for the treatment of knee osteoarthritis: a systematic review and meta-analysis

针刺治疗膝骨关节炎疗效及安全性的系统评价和Meta分析

Abstract

Objective

To evaluate the efficacy and safety of acupuncture for the treatment of knee osteoarthritis and to provide evidence for its use in clinical practice.

Methods

Eight databases were extensively searched up to March 2018. Randomized controlled trials (RCTs) comparing the efficacy of acupuncture with sham acupuncture or no acupuncture for knee osteoarthritis were included. Study selection, data extraction and quality assessment were independently conducted by two reviewers. The Cochrane Collaboration’s tool was used for assessing the risk of bias.

Results

A total of 18 RCTs were included, involving a total of 3 522 participants. The results showed that acupuncture was superior to sham acupuncture in relieving pain (SMD=−0.34, 95%CI: −0.57 to −0.11, l2=85%, P=0.003) and improving physical function (SMD=−0.34, 95%CI: −0.57 to −0.11, l2=85%, P=0.003). In comparison to the no-acupuncture group, the acupuncture group also showed significant advantages in relieving pain (SMD=−0.79, 95%CI: −1.15 to −0.43, l2=87%, P<0.0001) and improving physical function (SMD=−0.75, 95%CI: −1.19 to −0.31, l2=91%, P=0.0008). Sensitivity analyses suggested that the results were robust, and Egger’s test found no potential publication bias.

Conclusion

In the treatment of knee osteoarthritis, the acupuncture group had significant advantages over sham acupuncture or no-acupuncture groups in relieving pain and improving physical function.

摘要

目的

评估针刺治疗膝骨性关节炎的有效性及安全性, 并为其临床应用提供依据.

方法

共检索 8 个数据库, 检索时间从建库到 2018 年 3 月, 纳入分析针刺对比假针刺或针刺对比无针刺治疗膝骨性关节炎的随机对照试验. 两位评审员独立进行文献筛选、 数据提取和质量评估. 采用 Cochrane 风险评估工具评估纳入文献的偏 倚风险.

结果

纳入随机对照试验 18 个, 涉及总人数 3 522. 结果发现, 针刺组在缓解关节疼痛及改善关节功能方面均优于假针刺组[SMD=−0.34; 95%CI (−0.57, −0.11); I2=85%; P=0.003], [SMD=−0.34, 95%CI (−0.57, −0.11), I2=85%, P=0.003]. 针刺组对比无针刺组, 在缓解关节疼痛及改善关节功能方面同样显示显著优势[SMD=−0.79, 95%CI (−1.15, −0.43), I2=87%, P<0.0001), [SMD=−0.75, 95%CI (−1.19, −0.31), I2=91%, P=0.0008]. 敏感性分析提示结果稳固, Egger 检验也未发现潜在的发表偏倚.

结论

针刺组对比假针刺组或无针刺组在缓解膝骨性关节炎疼痛、 提高关节功能方面具有优势.

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Acknowledgments

This work was supported by grants from Project of Clinical Base Construction of Chinese Medicine Rehabilitation of Shanghai Health and Family Planning Commission (上海市卫计委中医康复临床基地建设项目, No. ZY3-LCPT-1-1008).

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Correspondence to Rui Qi.

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Author: Wang Ting-ting, M.M., resident physician

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Wang, Tt., Liu, Y., Ning, Zy. et al. Efficacy and safety of acupuncture for the treatment of knee osteoarthritis: a systematic review and meta-analysis. J. Acupunct. Tuina. Sci. 18, 180–190 (2020). https://doi.org/10.1007/s11726-020-1177-9

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  • DOI: https://doi.org/10.1007/s11726-020-1177-9

Keywords

  • Acupuncture Therapy
  • Osteoarthritis, Knee
  • Pain
  • Meta-analysis
  • Systematic Review
  • Randomized Controlled Trials

关键词

  • 针刺疗法
  • 骨关节炎, 膝
  • 疼痛
  • Meta 分析
  • 系统评价
  • 随机对照试验

中图分类号

  • R246.2

文献标志码

  • A