Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (23): 3756-3763.doi: 10.3969/j.issn.2095-4344.2729

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Various acupuncture therapies for lateral epicondylitis: a Bayesian network meta-analysis

Shi Yuling1, Li Guangyao2, Liang Zujian3   

  1. 1Third Clinical School, 2Acupuncture Rehabilitation School, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; 3Orthopedics Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510240, Guangdong Province, China
  • Received:2019-12-02 Revised:2019-12-04 Accepted:2020-01-10 Online:2020-08-18 Published:2020-07-30
  • Contact: Liang Zujian, MD, Chief physician, Orthopedics Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510240, Guangdong Province, China
  • About author:Shi Yuling, Master candidate, Third Clinical School, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Supported by:
    the National Natural Science Foundation of China (General Project), No. 81473756; the Natural Science Foundation of Guangdong Province, No. 2018A0303130103

Abstract:

BACKGROUND: Acupuncture therapy plays a very important role in the treatment of lateral epicondylitis. However, due to the diverse characteristics of acupuncture therapy, the current research mostly focuses on a simple comparison between acupuncture therapy and conventional blocking therapy.

OBJECTIVE: To compare the efficacy and visual analogue scale score of different acupuncture therapies for lateral epicondylitis using a Bayesian network meta-analysis.

METHODS: Randomized controlled trials on acupuncture therapy for lateral epicondylitis included in PubMed, The Cochrane Library, CNKI, VIP, and WanFang were searched. The search time was from inception until October 2019 in each database. Two researchers independently screened and extracted data according to the inclusion criteria, and then evaluated the quality of the literature. Direct meta-analysis and network meta-analysis of data were performed using ADDIS 1.16.8 software.

RESULTS AND CONCLUSION: A total of 2 318 lateral epicondylitis patients were included in 32 randomized controlled trials/controlled clinical trials, concerning 6 treatment measures, including warming needle, fire needle, electroacupuncture, filiform needle acupuncture, Fu’s acupuncture, fire needle plus filiform needle. Network meta-analysis results show that: in terms of efficiency, warming needles are better than electroacupuncture, warming needles are better than filiform needles, fire needles are better than warming needles, fire needles are better than electroacupuncture, fire needles are better than filiform needles, Fu’s acupuncture is better than electroacupuncture, Fu’s acupuncture is better than filiform needles, and fire needle plus filiform needle is better than filiform needles alone. In terms of the visual analogue scale score, warming needles are better than electroacupuncture, warming needles are better than filiform needles, fire needles are better than electroacupunture, fire needles are better than filiform needles, Fu’s acupuncture is better than electroacupuncture, Fu's acupuncture is better than filiform needles, fire needle plus filiform needle is better than electroacupuncture. Efficiencies rank from the best to the worst: Fu’s electroacupuncture>fire needle>fire needle plus filiform needle>warming needle>electroacupuncture needle>filiform needles. The visual analogue scale scores rank as follows: Fu’s acupuncture>fire needle+filiform needle>fire needle>warming needle>filiform needle>electroacupuncture. The direct meta-analysis results are highly consistent with the network meta-analysis results, indicating that there is consistency between the direct and indirect comparison, that is, transitive. In the clinical treatment of lateral epicondylitis, Fu’s acupuncture can be preferentially selected, but each acupuncture therapy has advantages and disadvantages. In clinical practice, the appropriate treatment should be selected in accordance with the actual situation and dialectical Chinese medicine.

Key words:  lateral epicondylitis, tennis elbow, acupuncture, network meta-analysis

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