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Therapeutic massage for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

推拿治疗膝骨关节炎: 随机对照试验系统评价与荟萃分析

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Journal of Acupuncture and Tuina Science Aims and scope Submit manuscript

Abstract

Objective

To evaluate the effectiveness of therapeutic massage (tuina) for treating knee osteoarthritis (KOA).

Methods

Six English and Chinese databases, including Chinese National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), Cochrane Library and PubMed databases, were independently searched to identify appropriate randomized controlled trials (RCTs) studying therapeutic massage for KOA compared to oral non-steroidal anti-inflammatory drugs (NSAIDs) alone. The main outcome measures were total effectiveness and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score.

Results

A total of 8 RCTs were included and they were of average quality. The results showed that therapeutic massage was more effective than NSAIDs comparing total effectiveness [risk ratio (RR)=1.14, 95% confidence interval (Cl) (1.07, 1.21), P<0.0001]; compared with NSAIDs, therapeutic massage produced more significant improvements in pain [mean difference (MD)=−2.06, 95%Cl (−2.75, −1.36), P<0.00001], stiffness intensity [MD=−0.90, 95%Cl (−1.05, −0.75), P<0.00001] and joint function [MD=−12.48, 95%Cl (−13.91, −11.05), P<0.00001].

Conclusion

Therapeutic massage was more effective than oral NSAIDs in treating KOA. In relieving pain and stiffness and improving the function of knee joint, therapeutic massage was superior to NSAIDs.

摘要

目的

系统评价推拿治疗膝骨关节炎(KOA)的疗效。

方法

共检索了6个中英文数据库, 包括中国知网(CNKI)、 万方学术期刊全文数据库(Wanfang)、重庆维普数据库(CQVIP)、中国生物医学文献数据库(CBM)、Cochrane图书馆 以及PubMed数据库, 筛选符合纳入标准的以推拿治疗KOA为研究对象并采用单独口服非甾体药物(NSAIDs)为对照 的临床随机对照试验。主要评价指标为总有效率及西安大略与麦克马斯特大学骨关节炎指数(WOMAC)评分。

结果

共纳入8篇符合纳入标准的文献, 文献质量中等。结果显示, 相较于NSAIDs药物, 推拿治疗膝骨关节炎有效率 更高[RR=1.14, 95%Cl (1.07, 1.21), P<0.0001]; 在改善疼痛[MD=−2.06, 95%Cl (−2.75, −1.36), P<0.00001]、僵硬程度[MD=−0.90, 95%Cl (−1.05, −0.75), P<0.00001]及关节功能[MD=−12.48, 95%Cl (−13.91, −11.05), P<0.00001]方面, 推拿效果更佳。

结论

推拿治疗膝骨关节炎比口服非甾体药物更有效; 在改善KOA患者膝关节疼痛、僵硬及日常功能方面, 推拿 手法优于非甾体药物治疗。

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Acknowledgments

This work was supported by the General Project of National Natural Science Foundation of China 国家自然 科学基金面上项目, No. 8197151584); Three-year Action Plan to Promote Clinical Skills and Clinical Innovation Capabilities of Municipal Hospitals (“促进市级医院临床 技能与临床创新能力” 三年行动计划, No. SHDC2020CR3096B); the Innovation Ability Project of Shanghai University of Traditional Chinese Medicine (上海 中医药大学研究生创新能力项目, No. Y2019079).

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Authors and Affiliations

  1. Department of Tuina, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China

    Xing Hua  (邢华), Gong Li  (龚利), Li Jian-hua  (李建华), Shao Sheng  (邵盛), Chu Yu-zhou  (储宇舟), He Peng-fei  (何鹏飞) & Chen Hao  (陈浩)

  2. Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China

    Shen Jia-yun  (沈佳韵)

  3. Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China

    Yao Fei  (姚斐)

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  1. Xing Hua  (邢华)
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Corresponding authors

Correspondence to Gong Li  (龚利) or Yao Fei  (姚斐).

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Co-first Authors

Xing Hua, M.M., physician; Shen Jia-yun, master degree candidate

Conflict of Interest

All authors declare that there are no conflicts of interest regarding the publication of this paper.

Authors’ Contributions

Xing Hua and Shen Jia-yun contributed equally to this work; Gong Li designed and supervised the study; Xing Hua, Shen Jia-yun, and Li Jian-hua contributed to literature search; Yao Fei, Shao Sheng, Chu Yu-zhou, He Peng-fei, and Chen Hao were responsible for the review and selection of trials and extraction of data. Xing Hua, Shen Jia-yun, Li Jian-hua, Yao Fei, and Chu Yu-zhou contributed to data analysis and interpretation. Xing Hua and Shen Jia-yun wrote the manuscript; Gong Li and Yao Fei revised the paper; all authors approved the final version of this article and the author list.

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Hua, X., Jia-yun, S., Li, G. et al. Therapeutic massage for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. J. Acupunct. Tuina. Sci. 19, 354–363 (2021). https://doi.org/10.1007/s11726-021-1266-4

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  • DOI: https://doi.org/10.1007/s11726-021-1266-4

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