Network meta-analysis on effectiveness of fire needle, warm
acupuncture, and electroacupuncture in the treatment of knee osteoarthritis

doi:10.3969/j.issn.2095-4344.2634

Abstract

Abstract:

BACKGROUND: Acupuncture has different forms as a kind of therapy, mainly warm acupuncture, fire needle and electroacupuncture, but the balance of effectiveness and safety between these measures remains unclear.

OBJECTIVE: To compare the effectiveness of warm acupuncture, fire needle and electroacupuncture in the intervention of knee osteoarthritis by network meta-analysis.

METHODS: The Embase, Cochrane Library, PubMed, CNKI, Wanfang, VIP and CBMdisc databases were searched for the clinical randomized controlled trials of warm acupuncture, fire needle and electroacupuncture in the treatment of knee osteoarthritis published before September 20, 2019. RevMan 5.3 and Stata 14.0 were used for data analysis.

RESULTS AND CONCLUSION: A total of 2 871 patients with knee osteoarthritis were included in 34 randomized controlled trials. The results of meta-analysis showed that (1) the total clinical effective rate in the fire needle group (OR=1.08, 95%CI: 1.00-1.17, P < 0.05) and warm acupuncture group (OR=1.08, 95%CI: 1.02-1.14, P < 0.05) was better than that in the electroacupuncture, and the total effective rate of the three acupuncture treatments was better than that of western medicine, especially fire needle. (2) In the aspect of improving the Visual Analogue Scale scores, the fire needle (MD=-2.12, 95%CI: -3.52 to -0.71, P < 0.05), warm acupuncture (MD=-1.31, 95%CI: -2.33 to -0.29, P < 0.05), and electroacupuncture (MD=-1.17, 95%CI: -2.19 to -0.16), P < 0.05) were superior to western medicine, especially fire needle. (3) In terms of reducing WOMAC scores, fire needle (MD=-15.38, 95%CI: -27.88 to -2.87, P < 0.05), warm acupuncture (MD=-11.48, 95%CI: -16.45 to -6.51, P < 0.05), and electroacupuncture (MD=-7.29, 95%CI: -11.86 to -2.72, P < 0.05) were superior to western medicine, especially fire needle. (4) In summary, comprehensive comparison of three kinds of acupuncture, in the treatment of knee osteoarthritis, fire needle is the first choice. However, it still needs to be confirmed by more high-quality randomized controlled trials.

Key words:

network meta-analysis, knee osteoarthritis, acupuncture, fire needle, electroacupuncture, tissue engineering

CLC Number:

Zhang Jinhuan, Chen Yirong, Lan Kai, Hu Liyu, Yu Haibo. Network meta-analysis on effectiveness of fire needle, warm acupuncture, and electroacupuncture in the treatment of knee osteoarthritis[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(18): 2945-2952.

Figures/Tables 16

对于风险偏倚方面，在随机方法方面，6项研究采用软件随机[19，22，26，29，36，45]，2项抽签随机[33，34]，均为低风险，1项描述为随机[17]，判为不清楚，其他均采用随机数字表法，为低风险；在分配隐藏方面，3项研究提及密闭信封[31，36，41]，因此为低风险，其他均未描述，判为不清楚；在盲法方面，1项研究提及双盲[22]，1项研究提及单盲[31]，其他均未描述；在结果完整性报告方面，6项研究提及脱落但均未进行意向性分析，因此为高风险，其他未描述，为不清楚；在选择性报告结局方面，纳入的34项研究均无预先注册方案，对于结果选择性报告均为不清楚。 2.3 传统Meta分析结果 2.3.1 对纳入的34项随机对照研究各结局指标不同干预措施之间直接比较的结果 ①在有效率方面：电针vs.温针，电针vs.氨基葡萄糖，电针vs.双氯酚酸纳，温针vs.双氯酚酸纳，温针vs.玻璃酸钠差异有显著性意义(P < 0.05)；②目测类比评分方面：电针vs.温针，火针vs.温针，电针vs.美洛昔康，温针vs.双氯芬酸钠，温针vs.氨基葡萄糖，温针vs.玻璃酸钠差异有显著性意义(P < 0.05)；③WOMAC疼痛症状评分方面：火针vs.温针，电针vs.温针，电针vs.美洛昔康，温针vs.双氯芬酸钠，温针vs.氨基葡萄糖均差异有显著性意义(P < 0.05)；④WOMAC僵硬症状评分方面：电针vs.温针，电针vs.塞来昔布，温针灸vs.双氯芬酸钠差异有显著性意义(P < 0.05)；⑤WOMAC日常活动难度评分方面：火针vs.温针，电针vs.双氯芬酸钠，电针vs.塞来昔布，温针vs.双氯芬酸钠差异有显著性意义(P < 0.05)；⑥WOMAC总分方面：电针vs.双氯酚酸纳，温针vs.双氯芬酸钠差异有显著性意义(P < 0.05)，具体结果见表2-7。 "

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