Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis

BMC Complementary and Alternative Medicine

Barbara L Shay⁴  Michael Tennenhouse³  Carol Friesen³  Ahmed Abou-Setta¹  Ryan Zarychanski¹  Maria Froese²  Taru Manyanga² 

[1] George & Fay Yee Center for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada;Surgery Rehabilitation Department, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada;Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Manitoba, Canada;Department of Physiotherapy, School of Medical Rehabilitation, University of Manitoba, Winnipeg, Manitoba, Canada

关键词: Meta-analysis;    Systematic review;    Health-related quality of life;    Functional mobility;    Pain;    Osteoarthritis;    Acupuncture;   

Others  :  1086904
DOI  :  10.1186/1472-6882-14-312

 received in 2013-11-28, accepted in 2014-08-18,  发布年份 2014

【 摘 要 】

Background

The utility of acupuncture in managing osteoarthritis symptoms is uncertain. Trial results are conflicting and previous systematic reviews may have overestimated the benefits of acupuncture.

Methods

Two reviewers independently identified randomized controlled trials (up to May 2014) from multiple electronic sources (including PubMed/Medline, EMBASE, and CENTRAL) and reference lists of relevant articles, extracted data and assessed risk of bias (Cochrane’s Risk of Bias tool). Pooled data are expressed as mean differences (MD), with 95% confidence intervals (CI) (random-effects model).

Results

We included 12 trials (1763 participants) comparing acupuncture to sham acupuncture, no treatment or usual care. We adjudicated most trials to be unclear (64%) or high (9%) risk of bias. Acupuncture use was associated with significant reductions in pain intensity (MD -0.29, 95% CI -0.55 to -0.02, I² 0%, 10 trials, 1699 participants), functional mobility (standardized MD -0.34, 95% CI -0.55 to -0.14, I² 70%, 9 trials, 1543 participants), health-related quality of life (standardized MD -0.36, 95% CI -0.58 to -0.14, I² 50%, 3 trials, 958 participants). Subgroup analysis of pain intensity by intervention duration suggested greater pain intensity reduction with intervention periods greater than 4 weeks (MD -0.38, 95% CI -0.69 to -0.06, I² 0%, 6 trials, 1239 participants).

Conclusions

The use of acupuncture is associated with significant reductions in pain intensity, improvement in functional mobility and quality of life. While the differences are not as great as shown by other reviews, current evidence supports the use of acupuncture as an alternative for traditional analgesics in patients with osteoarthritis.

Systematic review registration

CRD42013005405.

【 授权许可】

   
2014 Manyanga et al.; licensee BioMed Central Ltd.

【 图 表 】

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