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 [01 Jan 2024 18:08] Nguyen Johan [5.11. Gonarthrose] |
acupuncture:techniques instrumentales:04. aiguille-scalpel acupotomie [25 Oct 2025 11:34] (Version actuelle) Nguyen Johan [5.13. Talalgies] |
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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|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.| | ^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.| | ^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.| | ||
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| + | ==== Sciatique ==== | ||
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| + | * Lee S-H, Lee J-H, Choi H-K, Lee M-S, Choi S, Park S, Kim H-J, Kim YI, Kim YI, Lim YS, Park T-Y. Effectiveness of acupotomy combined with epidural steroid injection for lumbar radiculopathy: A systematic review and meta-analysis. Eur J Integr Med. 2025;77:102504. https://doi.org/10.1016/j.eujim.2025.102504 | ||
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| + | ^Background| Acupotomy—a combination of acupuncture and minimally invasive surgery—is a commonly used traditional East Asian medical intervention for treating patients with lumbar radiculopathy (LR). This study aimed to evaluate whether a combination of acupotomy and epidural steroid injections (ESIs) was more effective than ESIs alone or ESIs with interventions other than acupotomy for LR patients.| | ||
| + | ^Methods| Randomized controlled trials (RCTs) using acupotomy and ESIs in patients with LR were retrieved from thirteen databases on June 10, 2024 (PROSPERO CRD42023435441). Included studies assessed outcomes using the pain Visual Analogue Scale (VAS), total effective rate (TER), Oswestry Disability Index (ODI), and adverse events (AEs). Cochrane’s Risk of Bias Tool 2 (RoB2) was employed to assess the risk of bias, and the GRADE tool was used to assess evidence quality.| | ||
| + | ^Results| **Five studies involving 577 patients** were included. Compared with ESIs alone, the combination of acupotomy and ESIs led to improvement in pain VAS scores (three RCTs, standard mean difference [SMD] −0.73 [−1.01 to −0.45], very low certainty of evidence [CoE]) and TER (four RCTs, risk ratio 1.31 [1.02 to 1.69], very low CoE), although most studies were at high risk of bias in the RoB2 evaluation. However, the combination showed no improvement in ODI (two RCTs, SMD 0.46 [−1.58 to 2.50], very low CoE). No major AEs were reported.| | ||
| + | ^Conclusion| Although the quality of evidence was very low, combined acupotomy and ESIs proved more effective than ESIs alone for LR patients. Further rigorously designed studies are warranted to confirm the effects of this combination therapy.| | ||
| ==== 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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| ==== Talalgies ==== | ==== Talalgies ==== | ||
| + | * Li C, Sun ZW, Ma JX, Gao X, Lou HJ, Li CY. The curative effect of traditional Chinese medicine fumigation combined with acupotomy in the treatment of heel pain: A meta-analysis. Medicine (Baltimore). 2025 Aug 22;104(34):e43249. https://doi.org/10.1097/MD.0000000000043249 | ||
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| + | ^Background| To evaluate the clinical therapeutic effect of traditional Chinese medicine (TCM) fumigation combined with acupotomy for treatment of heel pain.| | ||
| + | ^Methods| After a comprehensive search of large databases globally, a meta-analysis was performed on the results of randomized controlled trials conforming to the inclusion criteria using Review Manager 5.4 software, and the quality of the evidence rated using the Grading of Recommendations Assessment, Development and Evaluation profiler 3.2.2 software.| | ||
| + | ^Results| A total of 1095 patients were included in 12 studies, with 548 in the treatment group and 547 in the control group. Heterogeneity test analysis showed no statistical heterogeneity among the 12 studies; therefore, a fixed-effects model combined with effect size analysis was used. The results of the meta-analysis showed that the clinical difference between the experimental and control groups was statistically significant. Grading of Recommendations Assessment, Development and Evaluation system evidence grading showed that the evidence grade of TCM fumigation combined with acupotomy for heel pain was low.| | ||
| + | ^Conclusion| The curative effect of TCM fumigation combined with acupotomy in the treatment of heel pain was better than that of medicine alone. The evidence quality level of this conclusion was not high, and the research conclusion should be treated with caution and further confirmed using large samples and high-quality clinical trials.| | ||
| - | Zhou Meng-Yuan, Luo Zheng-Jie , Hu Xuan-Ming , Chen Zhao-Ming. [Meta-analysis of Therapy Comparison of Acupotomy Versus Block Therapy for Heel Pain]. Chinese Journal of Basic Medicine in TCM. 2019;25(9):1280. {{:medias securises:acupuncture:evaluation:rhumatologie - orthopedie:zhou-202950.pdf|[202950]}}. | + | * Zhou Meng-Yuan, Luo Zheng-Jie , Hu Xuan-Ming , Chen Zhao-Ming. [Meta-analysis of Therapy Comparison of Acupotomy Versus Block Therapy for Heel Pain]. Chinese Journal of Basic Medicine in TCM. 2019;25(9):1280. {{:medias securises:acupuncture:evaluation:rhumatologie - orthopedie:zhou-202950.pdf|[202950]}}. |
| ^Methods| A computer-based research was conducted on PubMed database, Cochrane Library database, CNKI database, VIP database and Wanfang database of the clinical literature about randomized clinical trials (RCTs) of needle knife and block therapy for HP. Data were extracted and evaluated by two reviewers independently, and then cross check date with each other. The final data is imported into the software for Meta-analysis. | | ^Methods| A computer-based research was conducted on PubMed database, Cochrane Library database, CNKI database, VIP database and Wanfang database of the clinical literature about randomized clinical trials (RCTs) of needle knife and block therapy for HP. Data were extracted and evaluated by two reviewers independently, and then cross check date with each other. The final data is imported into the software for Meta-analysis. | | ||
| ^Results| Totally 9 RCTs involving 937 cases were included. The Mets-analysis showed that there was no significant difference between the experimental group and the control group for the short-term in the total effective rate and cure rate; The total effective rate and cure rate of the experimental group were higher than that of the control group for the long-term, The pain of the experimental group was lower than that of the control group for the short-term and long-term. | | ^Results| Totally 9 RCTs involving 937 cases were included. The Mets-analysis showed that there was no significant difference between the experimental group and the control group for the short-term in the total effective rate and cure rate; The total effective rate and cure rate of the experimental group were higher than that of the control group for the long-term, The pain of the experimental group was lower than that of the control group for the short-term and long-term. | | ||
