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| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
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acupuncture:techniques instrumentales:04. aiguille-scalpel acupotomie [22 Feb 2022 16:58] Nguyen Johan [5.11. Gonarthrose] |
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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| ==== Doigt à ressaut ==== | ==== Doigt à ressaut ==== | ||
| + | * 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 | ||
| + | ^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.| | ||
| - | * Xie Lishuang, Zhou Xuelong, Wang Zhanyou, Liang Dongyue. [Meta-analysis of curative effect of small needle knife therapy on stenosing tenovaginitis of flexor digitorum], | + | * 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. | |
| - | Shandong Journal of TCM. 2016;35(6):522-5. [168686]. | + | |
| + | ^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.| | ||
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| + | * 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]. | ||
| ^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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| ==== 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.| | ||
