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Meta Analysis of Randomized Controlled Trials of Warming Needle Moxibustion for Knee OsteoarthritisCN

ZHANG Jiwei;DENG Qiang;YANG Zhenyuan;ZHANG Yanjun;WANG Peng;GUO Tiefeng;Gansu Provincial Hospital of Traditional Chinese Medicine;

Abstract:Objective: To systematically evaluate the effectiveness of warming needle moxibustion and simple acupuncture or electroacupuncture in treating knee osteoarthritis. Methods: Retrieve the CNKI, Wanfang database, VIP,PubMed, Embase, and obtain the RCT literature about warm acupuncture and simple acupuncture or electroacupuncture in the treatment of KOA from the database to June 2018.According to the requirements of Cochrane evaluation manual 5.0.2, the experiment was screened and the data were extracted, and the methodological quality was evaluated according to the modified Jadad score.Total effective rate, VAS score, WOMAC score, remission time(pain, stiffness and average cure), and ISOA were selected as the indicators for meta-analysis.Stat e 12.0 software was used for metaanalysis,heterogeneity was tested, and the corresponding effect model was selected for analysis. Begg’s rank correlation test and Egger’s linear regression were used to test the literature publication bias. The counting and measurement data were expressed by RR, SMD and 95% CI respectively. Results: Twelve RCT papers were included, of which 6 were about the efficacy of warming acupuncture and simple acupuncture in the treatment of KOA, 6 were about the efficacy of warming acupuncture and electroacupuncture in the treatment of KOA, all of which were from China and included1176 subjects. Meta-analysis showed that there was no significant difference in the total effective rate of KOA between the two groups, RR = 1.04(95% CI: 1.00-1.08), Begg’s test P = 0.086, Egger’s test P = 0.296. After treatment, VAS scores were subgroup analyzed according to intervention measures. The results showed that there were significant differences in VAS scores between the two groups after treatment, SMD =-1.57(95% CI:-1.83 ~-1.80), and SMD = 0.32(95% CI:-0.11 ~0.76)as compared with electroacupuncture. There was no significant difference in total WOMAC score between warm acupuncture group and electroacupuncture group after treatment, SMD = 0.08(95% CI:-0.15 ~ 0.32).In terms of remission time, there were significant differences in pain and stiffness between warm acupuncture group and electroacupuncture group, SMD and 95% CI were 0.69(95% CI: 0.46-0.92)and-0.60(95% CI:-0.82-0.37), respectively,and there was no significant difference in mean cure time between the two groups, SMD =-0.04(95% CI:-0.27-0.18). The difference of ISOA index between warm acupuncture group and simple acupuncture group was statistically significant, SMD =-1.68(95% CI:-2.03 ~-1.32). Conclusion: Compared with acupuncture alone in the treatment of KOA, warm acupuncture can better relieve subjective pain and reduce the severity index of KOA in Lequesne, but the total effective rate is the same. Compared with electroacupuncture in treating KOA, warm acupuncture can alleviate knee stiffness more quickly, but there is no significant difference in total effective rate, subjective pain relief, WOMAC score reduction and average healing time, and in pain relief time, warm acupuncture is inferior to electroacupuncture.In view of the low quality of the included literature and the statistical heterogeneity between studies, high quality RCT is needed to verify the above conclusions.
  • DOI:

    10.16448/j.cjtcm.2018.0631

  • Series:

    (E) Medicine & Public Health

  • Subject:

    Traditional Chinese Medicine

  • Classification Code:

    R246.9

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