Différences
Ci-dessous, les différences entre deux révisions de la page.
| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
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acupuncture:techniques instrumentales:04. aiguille-scalpel acupotomie [24 Dec 2020 16:26] Nguyen Johan [5.8. Canal lombaire étroit] |
acupuncture:techniques instrumentales:04. aiguille-scalpel acupotomie [28 Aug 2025 19:20] (Version actuelle) Nguyen Johan [5.6. Névralgies cervico-brachiales] |
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| ^Materials and methods| All relevant studies up to February 19, 2019, were included, through comprehensive searches in 11 electronic databases without language restrictions. RESULTS: Eleven systematic reviews (SRs) comprising of 69 randomized controlled trials were included, and the methodological quality was medium-to-high in AMSTAR. All the included studies reviewed musculoskeletal disorders and reported a significantly higher total effective and cure rates in the acupotomy group for frozen shoulder, cervical spondylosis, third lumbar vertebrae transverse process syndrome, trigger finger, knee osteoarthritis, and lumbar spinal stenosis, compared to the other active control groups. | | ^Materials and methods| All relevant studies up to February 19, 2019, were included, through comprehensive searches in 11 electronic databases without language restrictions. RESULTS: Eleven systematic reviews (SRs) comprising of 69 randomized controlled trials were included, and the methodological quality was medium-to-high in AMSTAR. All the included studies reviewed musculoskeletal disorders and reported a significantly higher total effective and cure rates in the acupotomy group for frozen shoulder, cervical spondylosis, third lumbar vertebrae transverse process syndrome, trigger finger, knee osteoarthritis, and lumbar spinal stenosis, compared to the other active control groups. | | ||
| ^Conclusion| Acupotomy showed promising results for some musculoskeletal disorders; however, additional high-quality evidence is required to make clinical recommendations regarding this procedure.| | ^Conclusion| Acupotomy showed promising results for some musculoskeletal disorders; however, additional high-quality evidence is required to make clinical recommendations regarding this procedure.| | ||
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| + | ==== Céphalées de tension ==== | ||
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| + | Kwon CY, Yoon SH, Chung SY, Kim JW. Clinical Efficacy and Safety of Miniscalpel-Needle Treatment for Tension-Type Headache: A Systematic Review and Meta-Analysis. Chinese Journal of Integrative Medicine. 2020;26(9):713-720. [220317]. [[https://doi.org/10.1007/s11655-020-3179-3|doi]] | ||
| + | ^Objective|To investigate the clinical efficacy and safety of miniscalpel-needle (MSN) treatment for tension-type headache (TTH). | | ||
| + | ^Method|Seven medical databases were searched to identify randomized controlled trials (RCTs) evaluating the effect and safety of MSN treatment. All articles published up to November 15, 2018 were retrieved. A meta-analysis was conducted for the included studies, and the risk of bias was assessed. Primary outcomes were visual analogue scale (VAS) or numeric rating scale (NRS) score. Secondary outcomes were clinical effective rates including total effective rate (TER), markedly effective rate (MER), and totally cured rate (TCR) determined by improvement in clinical symptoms or VAS scores, the frequency of adverse events (AEs) that occurred during the study, and participant quality of life (QOL).| | ||
| + | ^ Results| Seven RCTs involving 724 participants were included. MSN treatment showed significantly higher MER and TCR [relative risk (RR) 1.27, 95% confidence interval (CI) 1.01 to 1.61; RR 1.31, 95% CI 1.09 to 1.57, respectively], but not TER (RR 1.03, 95% CI 0.96 to 1.10) compared to acupuncture. MSN treatment plus conventional treatment showed significant lower VAS and higher TER, MER, and TCR (mean difference -3.54, 95% CI -3.80 to -3.28; RR 1.14, 95% CI 1.06 to 1.23; RR 2.31, 95% CI 1.50 to 3.58; RR 3.01, 95% CI 2.25 to 4.02, respectively) compared to conventional treatment. | | ||
| + | ^ Conclusions| According to current evidence, MSN treatment as a monotherapy or as an adjunctive treatment to other existing treatments might have benefits on treating TTH. However, since the number and the sample size of studies included were both small and the methodological quality was poor, the findings of this review should be interpreted with great caution, and our confidence in the results is low. A high quality RCT using objective outcomes should be performed on this topic.| | ||
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| ==== Doigt à ressaut ==== | ==== Doigt à ressaut ==== | ||
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| + | * Liang YS, Chen LY, Cui YY, Du CX, Xu YX, Yin LH. Ultrasound-guided acupotomy for trigger finger: a systematic review and meta-analysis. J Orthop Surg Res. 2023 Sep 13;18(1):678. https://doi.org/10.1186/s13018-023-04127-3 | ||
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| + | ^Background| Trigger finger is a common condition in the hand, and ultrasound-guided acupotomy for trigger finger has been widely used in recent years.| | ||
| + | ^Purpose| This study aims to investigate the efficacy and safety of ultrasound-guided acupotomy for trigger finger.| | ||
| + | ^Methods| We searched for relevant studies in the Cochrane Library, China National Knowledge Infrastructure (CNKI), Embase, PubMed, Chinese Biomedical Literature Database (CBM), Wanfang Data, and other resources from their inception to January 2023. Randomized controlled trials of ultrasound-guided acupotomy for trigger finger were included. The meta-analysis was carried out using Review Manager 5.4 and Stata 15.1.| | ||
| + | ^Results| Overall, **15 studies with 988 patients** were included. The experimental group was treated with ultrasound-guided acupotomy, and the Control group received traditional acupotomy, traditional operation or injection of medication. Meta-analysis showed that the overall clinical effectiveness (OR = 4.83; 95% CI 2.49-9.37; I2 = 73.1%; P < 0.001) in the experimental group was significantly better than that of the control group. And the Visual Analogue Scale (VAS) score (WMD = - 1; 95% CI - 1.24, - 0.76; I2 = 99%; P < 0.001), the QuinneII classification (WMD = - 0.84; 95% CI - 1.28, - 0.39; I2 = 99.1%, P < 0.001), the incidence of complications (RR = 0.26; 95% CI 0.11, 0.63; I2 = 0%, P = 0.003), and the recurrence rate (RR = 0.14; 95% CI 0.03, 0.74; I2 = 0%; P = 0.021) were significantly lower in the experimental group.| | ||
| + | ^Conclusion| Our systematic review and meta-analysis can prove the effectiveness and safety of ultrasound-guided acupotomy in the treatment of trigger finger, but this still needs to be verified by a clinical standard large sample test.| | ||
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| + | * Li D, Wang X, Fang T, Chen Y, Xiang S, Qi J, Liang C, Ren C, Zhao X, Qiu Z, Liu F, Yan X. Acupotomy in the treatment of tenosynovitis of hand flexor tendons: A systematic review and meta-analysis. Medicine (Baltimore). 2022 Nov 11;101(45):e31504. https://doi.org/10.1097/MD.0000000000031504. | | ||
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| + | ^Background| Acupotomy was used to treat tenosynovitis of hand flexor tendons (THFT) in China. But it's uncertain about the efficacy of acupotomy for THFT. We plan to evaluate the efficacy and safety about acupotomy therapy in the treatment of THFT through this review.| | ||
| + | ^Methods|The protocol about this review was registered in PROSPERO (registration number: CRD42022330568). We searched 6 databases from their respective inception dates to January 11, 2022. Studies searched was screened by our reviewers, and then the raw data was filtered out. We used RevMan 5.3 software to perform statistical analysis.| | ||
| + | ^Results|**11 studies involving 828 patients** were shortlisted. The experimental group showed obvious advantages compared with the control group, such as effective rate (odds ratio [OR] = 6.77, 95% CI [confidence intervals] = [3.89, 11.77], P < .00001), cure rate (OR = 3.32, 95% CI = [1.81, 6.11], P = .0001) and Vas score (MD = -1.21, 95% CI = [-2.00, -0.42], Z = 3.01, P < .003).| | ||
| + | ^Conclusions|According to the above results, Acupotomy is an effective and safe treatment for THFT. So it should be recommended for the treatment of THFT patients.| | ||
| - | * Xie Lishuang, Zhou Xuelong, Wang Zhanyou, Liang Dongyue. [Meta-analysis of curative effect of small needle knife therapy on stenosing tenovaginitis of flexor digitorum], | + | * Xie Lishuang, Zhou Xuelong, Wang Zhanyou, Liang Dongyue. [Meta-analysis of curative effect of small needle knife therapy on stenosing tenovaginitis of flexor digitorum]. Shandong Journal of TCM. 2016;35(6):522-5. [168686]. |
| - | Shandong Journal of TCM. 2016;35(6):522-5. [168686]. | + | |
| ^Objective|To compare the curative effect and safety of small needle knife therapy and blocking therapy on stenosing tenovaginitis of flexor digitorum by system evaluation.| | ^Objective|To compare the curative effect and safety of small needle knife therapy and blocking therapy on stenosing tenovaginitis of flexor digitorum by system evaluation.| | ||
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| ==== Névralgies cervico-brachiales ==== | ==== Névralgies cervico-brachiales ==== | ||
| + | * Choi HK, Lee SH, Lee JH, Choi S, Park S, Lim YS, Kim HJ, Kim YI, Park TY. Effectiveness of acupotomy combined with nerve block therapy for cervical radiculopathy: A systematic review and meta-analysis. Medicine (Baltimore). 2025 Jun 13;104(24):e42771. https://doi.org/10.1097/MD.0000000000042771 | ||
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| + | ^Backgound| This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of combining acupotomy with nerve block therapy (NBT) for cervical radiculopathy (CR) compared to NBT alone.| | ||
| + | ^Methods| A comprehensive search was conducted across multiple databases to identify randomized controlled trials (RCTs) investigating the combined use of acupotomy and NBT for CR. Studies were assessed for risk of bias using the Cochrane Risk of Bias 2 tool. Data were synthesized through meta-analysis where applicable.| | ||
| + | ^Results|** Four RCTs with a total of 540 patients** were included. Meta-analysis showed that the combination of acupotomy and NBT significantly improved the total effective rate compared to NBT alone (risk ratio 1.16, 95% confidence interval 1.08-1.24, P < .0001). However, no significant pain reduction was observed based on the pain visual analog scale (SMD - 2.55, 95% confidence interval -5.32 to 0.22, P = .07), and there was substantial heterogeneity among the included studies (I² = 99%). The overall risk of bias was high, and safety data were limited, with only one study reporting adverse events.| | ||
| + | ^Conclusion| The findings suggest that acupotomy combined with NBT may enhance treatment effectiveness for CR, particularly in terms of overall therapeutic response. However, due to the high risk of bias, study heterogeneity, and insufficient safety reporting, further well-designed, large-scale RCTs with long-term follow-ups are needed to establish robust clinical evidence.| | ||
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| ^Results| 8 articles were included with 1 329 patients, 665 cases in the treatment group and 664 cases in the control group. According to the meta-analysis, 8 studies were homogenous (Chi~2=4. 40, df=7, P = 0. 73>0. 1), and the fixed effect model was used for analysis and calculation. After OR combined, Z = 9. 32, P < 0. 00001, indicating that the effect of the simple needle knife group was superior to other traditional treatment groups.| | ^Results| 8 articles were included with 1 329 patients, 665 cases in the treatment group and 664 cases in the control group. According to the meta-analysis, 8 studies were homogenous (Chi~2=4. 40, df=7, P = 0. 73>0. 1), and the fixed effect model was used for analysis and calculation. After OR combined, Z = 9. 32, P < 0. 00001, indicating that the effect of the simple needle knife group was superior to other traditional treatment groups.| | ||
| ^Conclusion| The clinical effect of simple needle knife on LDH is better than other traditional therapies, such as acupuncture, physiotherapy, massage, electroacupuncture and traction.| | ^Conclusion| The clinical effect of simple needle knife on LDH is better than other traditional therapies, such as acupuncture, physiotherapy, massage, electroacupuncture and traction.| | ||
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| * Wang Dexiang. [Network meta-analysis of needle knife and needle knife combined with other therapies in the treatment of lumbar disc herniation]. China Medical Herald. 2020. [212920]. | * Wang Dexiang. [Network meta-analysis of needle knife and needle knife combined with other therapies in the treatment of lumbar disc herniation]. China Medical Herald. 2020. [212920]. | ||
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| ^Objective|To systematically evaluate the effect of needle knife and needle knife combined with other therapies in the treatment of lumbar disc herniation (LDH) by network meta-analysis.| | ^Objective|To systematically evaluate the effect of needle knife and needle knife combined with other therapies in the treatment of lumbar disc herniation (LDH) by network meta-analysis.| | ||
| ^Methods| The following databases were searched online: PubMed, Cochrane Library, CNKI, Wanfang database, VIP and China biomedical literature database (CBMdisc). The search was conducted using a combination of subject words and free words. The search keywords included needle knife, sharp needle and lumbar disc herniation. The search time limit was from January 2009 to July 2019. Two investigators independently screened the literature, extracted the data and evaluated the risk of bias in the included studies. Data was analyzed using Stata 15. 0, ADDIS v1. 16. 8 and Review Manager 5. 3 software.| | ^Methods| The following databases were searched online: PubMed, Cochrane Library, CNKI, Wanfang database, VIP and China biomedical literature database (CBMdisc). The search was conducted using a combination of subject words and free words. The search keywords included needle knife, sharp needle and lumbar disc herniation. The search time limit was from January 2009 to July 2019. Two investigators independently screened the literature, extracted the data and evaluated the risk of bias in the included studies. Data was analyzed using Stata 15. 0, ADDIS v1. 16. 8 and Review Manager 5. 3 software.| | ||
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| + | * Zhou Fanyuan, Liu Fushui, Zhao Meimei, Fang Ting, Chen Mei. [Systematic Review and Meta-analysis of Acupotomy Versus Acupuncture for Lumbar Intervertebral Disc Herniation]. Liaoning Journal of Traditional Chinese Medicine. 2017;03:. [52381]. | ||
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| + | ^Objective| To evaluate the effectiveness and safety of acupotomy versus acupuncture for lumbar intervertebral disc herniation. | | ||
| + | ^Methods| CNKI, Wanfang, VIP, Pub Med and The Cochrane Library (Issue1, 2016) were retrieved to identify randomized controlled trials of acupotomy versus acupuncture for lumbar intervertebral disc herniation. The data was extracted and evaluated by two reviewers independently according to Cochrane Reviewers’ Handbook (5. 0). The Cochrane Collaboration’s Rev Man 5. 2 software was used for Meta-analyses.| | ||
| + | ^ Results| A total of 8 trials involving 772 patients were included. The Meta-analysis showed that both total effective rate and curative rate of acupotomy for the treatment of lumbar intervertebral disc herniation were higher than those of acupuncture in short term and long-term and the recurrence rate of the acupotomy was lower than that of acupuncture.| | ||
| + | ^Conclusion|It showed that acupotomy was more effective than acupuncture in the treatment of lumbar intervertebral disc herniation.| | ||
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| + | * Zhang LY , Ye Y , Shao XN et al. [Meta - analysis of needle - knife therapy for lumbar intervertebral disc protrusion]. Journal of Clinical Acupuncture and Moxibustion. 2014;30(2):49.{{:medias securises:acupuncture:evaluation:rhumatologie - orthopedie:zhang-169608.pdf|}}. | ||
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| + | ^Objective |To discuss the clinical curative effect of needle knife therapy on lumbar intervertebral disc protrusion and provide evidence - based medical evidence for clinical practice. | | ||
| + | ^Methods|Comprehensively search CNKI (1989 - 2012), VIP( 1989 - 1989) , Wanfang( 1989 - 2012) , such as database, collect clinical randomized controlled trials about needle knife in the treatment of lumbar intervertebral disc protrusion. After screening, finally 12 standard articles were found as Meta analysis objects. Use Review Manage5. 0 specialized software Cochrane provided freely for statistical analysis.| | ||
| + | ^Results|12 researches by Meta analysis combined showed that **12 studies** homogeneity test results, Chi square is 4. 65, degrees of freedom was 1 1 (P = 0. 95 >0,1), and 12 studies had homogeneity , so use the fixed effects model to analyze , calculate and summarize statistics. OR combination checked by Z: Z = 7.94(P<0.00001), which suggested that needle knife compared with other treatments had a statistical significance.| | ||
| + | ^Conclusion|**Current clinical evidence suggests that the curative effect of small needle knife therapy on lumbar intervertebral disc protrusion is better than electric acupuncture, massage, traction therapy**. But with this research low methodological quality, limited sample size, it needs more large samples of reasonable esign,execution,strict,scientific and standardization,and high quality clinical randomized controlled trials are needed to further verify its effectiveness.| | ||
| ==== Gonarthrose ==== | ==== Gonarthrose ==== | ||
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| + | * Zhang J, Pang T, Yao J, Li A, Dong L, Wang Y, Wang Y. Acupotomy therapy for knee osteoarthritis: An overview of systematic reviews. Medicine (Baltimore). 2024 Nov 22;103(47):e39700. https://doi.org/10.1097/MD.0000000000039700 | ||
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| + | ^Backgound| This study aimed to evaluate the methodological quality, report quality, and evidence quality of a meta-analysis (MA) and systematic review (SR) of the efficacy of acupotomy in the treatment of knee osteoarthritis (KOA), and provided a reference for clinical decision-making.| | ||
| + | ^Methods| We searched 8 databases to collect systematic reviews and meta-analyses on the efficacy of acupotomy in the treatment of KOA from January 30, 2018, to January 31, 2023. The methodological quality of the studies was assessed using the assessment of multiple systematic reviews (AMSTAR) 2 scale, the quality of the literature reports was scored using the Preferred Reporting Items for Systems Reviews and Meta-Analyses 2020 Version (PRISMA 2020),and the quality of the evidence was graded using the grading of recommendations assessment, development, and evaluation (GRADE) scale.| | ||
| + | ^Results| **Nine systematic reviews** including 35 outcome indicators were included. AMSTAR 2 evaluated the methodological quality of the included studies, and 1 was of low quality, 8 were of very low quality, and the entries with poor scores were 2, 3, 4, 8, 10, 12, and 13. By PRISMA 2020, there were some reporting deficiencies, and quality problems were mainly reflected in the abstract, information sources, search strategy, synthesis methods, reporting bias assessment, certainty assessment, reporting biases, certainly of evidence, registration and protocol. The GRADE classification results showed that there were 2 medium-quality evidences, 7 low-quality evidences, and 26 very low-quality evidences. The main factors of degradation were limitations, imprecision, and publication bias.| | ||
| + | ^Conclusion| Acupotomy had been a promising complementary treatment for KOA. However, due to the low quality of the SRs/MAs supporting these results, high-quality studies with rigorous study designs and larger samples were needed before widespread recommendations could be made. | | ||
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| + | * Lee CJ, Luo WT, Tam KW, Huang TW. Comparison of the effects of acupotomy and acupuncture on knee osteoarthritis: A systematic review and meta-analysis. Complement Ther Clin Pract. 2023 Feb;50:101712. https://doi.org/10.1016/j.ctcp.2022.101712 | ||
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| + | ^Background and purpose| Acupotomy and acupuncture are both treatments for knee osteoarthritis symptoms. However, acupotomy also has the additional anatomical effect of dissecting inflamed tissue. The problem this study aims to address is whether acupotomy is a better treatment than acupuncture in treating knee osteoarthritis.| | ||
| + | ^Methods| We searched the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Airiti Library, and Wanfang Data databases from inception to March 2022 for randomized controlled clinical trials (RCTs) comparing the effects of acupotomy and acupuncture in patients with knee osteoarthritis.| | ||
| + | ^Results|In total, we identified **43 RCTs** in this meta-analysis. Compared to the acupuncture group, acupotomy had a higher cure rate (odds ratio (OR) 2.94, 95% confidence interval (CI) 2.36 to 3.65), indicating a better improvement in daily activity function. Acupotomy was also more effective in pain relief and knee score improvement. However, some RCTs indicated that adverse events in the acupotomy group were greater than in the acupuncture group (OR 1.23, 95% CI 0.42 to 3.60).| | ||
| + | ^Conclusion| Our findings indicated that acupotomy was a more effective treatment for knee osteoarthritis than acupuncture. However, most of the included RCTs had moderate risk of bias, meaning that more high-quality RCTs were needed.| | ||
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| + | * Lin S, Lai C, Wang J, Lin Y, Tu Y, Yang Y, Zhang R. Efficacy of ultrasound-guided acupotomy for knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2023 Jan 13;102(2):e32663. https://doi.org/10.1097/MD.0000000000032663. | ||
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| + | ^Background| This systematic review aimed to evaluate the effectiveness and safety of ultrasound-guided acupotomy (UGAT) therapy in the treatment of patients with knee osteoarthritis (KOA).| | ||
| + | ^Methods|We conducted online researches in the databases including PubMed, the Cochrane Library, EMBASE, China national knowledge infrastructure, China biomedical literature database, and Wan Fang data. All data were collected until January 1, 2022. Relevant randomized controlled trials on the effectiveness of UGAT for the treatment of KOA were included. Meta-analyses were carried out by RevMan 5.3 software. Evidence quality was evaluated by the grading of recommendations, assessment development, and evaluation.| | ||
| + | ^Results|**Eight studies** including **543 participants** were analyzed in this study. The pooled analysis indicated that UGAT was significantly more efficient than the control group in decreasing the visual analogue scale score (mean difference = -0.81, 95% confidence interval (CI) = [-1.15, -0.47], P < .00001, 8 studies), improving knee function on the Lysholm knee score (mean difference = 8.26, 95% CI = [1.56, 14.97], P = .02, 2 studies), and increasing clinical effective rate (relative risk = 1.14, 95% CI = [1.06, 1.23], P = .0005, 6 studies). For adverse events, UGAT was also associated with lower incidence of adverse event (odds ratio = 0.27, 95% CI = [0.12, 0.63], P = .002, 4 studies) compared to traditional acupotomy.| | ||
| + | ^Conclusion|Current evidence suggested that UGAT therapy was effective and safe in the clinical treatments of KOA, thus could be suggested in the clinical managements of KOA. However, considering the unsatisfactory quality of the available trials, more large-scale, and better quality randomized controlled trials were recommend in future.| | ||
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| + | * Wu Q, Wu Z, Lu Z. Efficacy of acupotomy combined with sodium hyaluronate versus sodium hyaluronate alone in the treatment of knee osteoarthritis: A meta-analysis. Medicine (Baltimore). 2023 Sep 15;102(37):e34930. https://doi.org/10.1097/MD.0000000000034930. | ||
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| + | ^Background| The efficacy of acupotomy combined with hyaluronic sodium acid in the treatment of knee osteoarthritis (KOA) is unclear. Therefore, this meta-analysis aims to evaluate the efficacy of acupotomy combined with hyaluronic sodium acid compared with hyaluronic sodium acid alone in the treatment of KOA.| | ||
| + | ^Methods| Studies from 8 Online databases were searched on KOA treatment using acupotomy combined with sodium hyaluronate until May 2022. The primary outcome indicator was clinical effectiveness, and the secondary outcome indicators included the visual analogue scale scores and Lysholm scores. We calculated the weighted mean difference (WMD) or relative risk for all relevant outcomes.| | ||
| + | ^Results| **Nine studies were identified, involving 644 cases**. The results showed that acupotomy combined with intra-articular sodium hyaluronate injection for KOA was superior to sodium hyaluronate injection alone in terms of clinical effectiveness (relative risk = 1.17, 95% confidence interval [CI]: 1.09-1.25, P < .001) and visual analogue scale (WMD = -2.1, 95% CI: -2.25 to 1.95, P < .001), Lysholm score (WMD = 13.83, 95% CI: 3.47-24.19, P = .009).| | ||
| + | ^Conclusion| Acupotomy combined with intra-articular sodium hyaluronate injection for KOA is superior to sodium hyaluronate injection alone. Limited by the number and quality of included studies, this conclusion still needs to be verified by more high-quality Research.| | ||
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| + | * Yin X, Liu Y, Liu W, Liang W, Liang Q. Blade needle therapy versus conventional acupuncture for knee osteoarthritis: A meta-analysis. Medicine (Baltimore). 2022 Jul 29;101(30):e29647. https://doi.org/10.1097/MD.0000000000029647 | ||
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| + | ^Background| This study investigated the hypothesis that the efficacy of blade needle therapy for the treatment of knee osteoarthritis (KOA) is superior to that of conventional acupuncture. In addition, the efficacy of blade needle therapy versus conventional acupuncture for the treatment of KOA was analyzed in a meta-analysis.| | ||
| + | ^Methods| Randomized controlled trials (RCTs) of blade needle therapy and conventional acupuncture for treating KOA were retrieved from the electronic databases CNKL, Wanfang, VIP, PubMed, EMBASE and the Cochrane Library from the commencement of each database to July of 2021. Data were extracted and evaluated by 2 reviewers independently. RevMan 5.3 software was used to conduct the meta-analysis after the studies were evaluated.| | ||
| + | ^Results| A total of 11 RCTs were included, all from China, involving 1142 patients. The meta-analysis results showed that the effective rate of the blade needle group was better than that of the conventional acupuncture group (OR = 3.61, 95% CI [2.56-5.10], P < .00001).| | ||
| + | ^Conclusion| The efficacy of blade needle treatment for KOA is superior to that of conventional acupuncture, but more high-quality studies are needed for future validation due to the low proportion of high-quality studies included and the possible bias factor.| | ||
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| + | * Seung Min Lee, Cham Kyul Lee, Kyung Ho Kim, Eun Jung Kim, Chan Yung Jung, Byung-Kwan Seo, Bon Hyuk Goo, Yong Hyeon Baek, Eun Yong Lee. Acupotomy for Osteoarthritis of the Knee; A Systematic Review and Meta-Analysis. J Acupunct Res. 2021;38(2):96-109. [219985]. [[https://doi.org/10.13045/jar.2020.00339|doi]] | ||
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| + | ^Purpose| The purpose of this study was to evaluate the effectiveness and safety of acupotomy for the treatment of patients with knee osteoarthritis. | | ||
| + | ^Methods|There were 9 databases searched to retrieve randomized controlled trials until August 3, 2019 regarding acupotomy versus conventional Western medicine, conventional Western medicine treatment with and without acupotomy, and Korean medicine treatment with and without acupotomy, and meta-analysis was performed. | | ||
| + | ^Results|Of 303 potentially relevant studies retrieved, 43 were systematically reviewed. All studies were conducted in China. Effective rate, visual analogue scale, and Western Ontario and McMaster Universities Osteoarthritis index were used as the evaluation scales. The Ashi point was selected most frequently. In all studies, the intervention group was more effective than the control group. Meta-analysis revealed that acupotomy showed statistically significant beneficial results. | | ||
| + | ^Conclusion| Although acupotomy had a beneficial effect on knee osteoarthritis, the risk of bias of the included studies was not low. The majority of the results from the evaluation scales used were highly heterogeneous (> 50%) which reduced confidence in the estimation of effect, or had a small sample size. Further clinical research and development is required in the future. | | ||
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| + | * Qu B, Wu X, Liu H, Cai W, Wang G, Song H, Wang F. Meta-analysis and systematic review of acupotomy combined with puncture and moxibustion in the treatment of knee osteoarthritis. Ann Palliat Med. 2021;10(6):6637-6649. [220191]. [[https://doi.org/10.21037/apm-21-1083|doi]] | ||
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| + | ^Background|This study aimed to systematically evaluate the therapeutic effects of acupotomy combined with acupuncture and moxibustion on knee osteoarthritis (KOA), which was expected to provide a reference for clinical treatment of KOA using traditional Chinese medicine (TCM). | | ||
| + | ^Methods| The databases PubMed, Embase, Medline, Ovid, and Springer were searched to retrieve randomized controlled trials (RCTs) on KOA treatment by acupotomy combined with acupuncture and moxibustion. The search time was set as from the date the database was established to 31 December 2020. The Cochrane Handbook for Systematic Reviews of Intervention 5.0.2 was used to conduct bias risk assessment on the included literature, and Review Manager 5.3 software was used for meta-analysis. | | ||
| + | ^Results| A total of 10 RCTs were included in this study, including 1,073 participants. Meta-analysis results showed that compared with the control group, the clinical treatment efficiency of the experimental group was higher [mean difference (MD) =5.72; 95% confidence interval (CI): 3.39 to 9.64; Z=6.54; P<0.00001], and the postoperative visual analogue scale (VAS) scores were reduced (MD =-1.72; 95% CI: -2.41 to -1.03; Z=4.86; P<0.00001). | | ||
| + | ^Discussion| Acupotomy combined with acupuncture and moxibustion treatment for KOA can increase clinical treatment efficiency, and relieve postoperative pain, suggesting that the combination of acupotomy, acupuncture, and moxibustion has better therapeutic effects on KOA and can be promoted clinically. | | ||
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| + | * Fang T, Li Q, Zhou F, Liu F, Liu Z, Zhao M, Chen M, You J, Jin Y, Xie J. Effect and safety of acupotomy in treatment of knee osteoarthritis: a systematic review and Meta-analysis. Journal of TCM. 2020;40(3):355-364. [221075]. https://doi.org/10.19852/j.cnki.jtcm.2020.03.002 | ||
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| + | ^ Objective| To evaluate the clinical efficacy and safety of acupotomy in treatment of knee osteoarthritis (OA). | | ||
| + | ^Methods| Extensive literature searches were carried out in PubMed, EMBASE, Cochrane Library (Issue 5, 2017), Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, China Science and Technology Journal Database and Wanfang Database. All databases were retrieved from their inception until May 31, 2017. Randomized controlled trials incorporating acupotomy versus intra-articular sodium hyaluronate for knee osteoarthritis were included. According to Cochrane Reviews' Handbook (5.2), two reviewers screened each article and extracted data independently and were blinded to the findings of each reviewer. Meta-analysis was performed by the Cochrane Collaboration's RevMan 5.3 software. | | ||
| + | ^Results| We identified **12 studies involving 1150 patients** aged between 40 and 78 years old. The pooled analysis indicated that acupotomy showed a significant improvement for short-term effect [cure rate: odds ratio (OR) = 2.04, 95% confidence interval (CI) (1.46, 2.85), P < 0.01; total effective rate: OR = 2.25, 95% CI (1.55, 3.28), P < 0.01; pain score: standard mean difference (SMD) = －1.02; 95% CI (－1.72, －0.31); P = 0.005; Western Ontario and McMaster Universities Questionnaire (WOMAC) score: SMD = －0.74; 95% CI (－1.11, －0.37); P < 0.01]; and also for long-term effect [total effective rate: OR = 2.99, 95%CI (1.88, 4.76), Z = 4.64, P < 0.01; pain score: SMD = －1.68; 95% CI (－2.14, －1.22); P < 0.001; WOMAC score: SMD = －0.91; 95% CI (－1.40, －0.41); P < 0.001]. In addition, there was no obvious difference between acupotomy group and control group in adverse events [OR = 2.13, 95%CI (0.14, 32.28), P = 0.58]. | | ||
| + | ^Conclusion| Acupotomy is a safe and effective treatment for KOA. However, due to the methodological deficiency of the included studies, well-designed randomized controlled trials are required to further confirm the findings.| | ||
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| + | * Sun J, Zhao Y, Zhu R, Chen Q, Song M, Xue Z, Wang R, Chen W. Acupotomy Therapy for Knee Osteoarthritis Pain: Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2020. {{:medias securises:acupuncture:evaluation:rhumatologie - orthopedie:sun-213667.pdf|[213667]}}. [[https://doi.org/10.1155/2020/2168283|doi]] | ||
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| + | ^Background and Purpose|Knee osteoarthritis (OA) is a major public health problem, and currently, few effective medical treatments exist. Chinese acupotomy therapy has been widely used for the treatment of knee OA in China. We conducted this systematic review and meta-analysis to evaluate the efficacy of Chinese acupotomy in treating knee OA to inform clinical practice.| | ||
| + | ^Methods|We performed a comprehensive search on PubMed, the Cochrane Library, EMBASE, and four Chinese databases for articles published prior to June 2020. We included only randomized controlled trials (RCTs) that used acupotomy therapy as the major intervention in adults with knee OA, were published in either Chinese and English, included more than 20 subjects in each group, and included pain and function in the outcome measures. Knee OA was defined by the American College of Rheumatology or Chinese Orthopedic Association criteria in all studies. We extracted the visual analogue scale (VAS) pain score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score, the total effectiveness rate, the modified Japanese Orthopedic Association (JOA) activities of daily living score, and Lysholm's score. We calculated the mean difference (MD) or risk ratio (RR) for all relevant outcomes. Meta-analyses were conducted using random-effects models when appropriate.| | ||
| + | ^ Results| We identified 1317 potentially relevant studies, **thirty-two** of which met the eligibility criteria and were conducted in China between 2007 and 2020. A total of **3021 knee OA patients** (62.96% female, median age: 57 years, and median disease duration: 33 months) were included. The treatment duration ranged from 1 week to 5 weeks (median: 3 weeks). The typical acupotomy treatment involved releasing soft tissue adhesions and was performed once a week for 1-5 weeks until the pain was relieved. The control group treatments included acupuncture (8 studies), electroacupuncture (10 studies), sodium hyaluronate (8 studies), radiofrequency electrotherapy (1 study), and nonsteroidal anti-inflammatory drugs (NSAIDs, 5 studies). The results from the meta-analysis showed that acupotomy led to superior improvements in the VAS pain score (MD = -1.11; 95% confidence interval (CI), -1.51 to -0.71; p < 0.00001) and WOMAC pain score (MD = -2.32; 95% CI, -2.94 to -1.69; p < 0.00001), a higher total effectiveness rate (RR = 1.15; 95% CI, 1.09-1.21; p < 0.00001), and superior improvements in the JOA score (MD = 6.39; 95% CI, 4.11-9.76; p < 0.00001) and Lysholm's score (MD = 12.75; 95% CI, 2.61-22.89; p = 0.01) for overall pain and function. No serious adverse events were reported. | | ||
| + | ^Conclusion|Chinese acupotomy therapy may relieve pain and improve function in patients with knee OA. Furthermore, rigorously designed and well-controlled RCTs are warranted. | | ||
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