Meta-analysis of the efficacy of acupuncture in the treatment of low back fasciitis

Am J Transl Res. 2023 Aug 15;15(8):5486-5494. eCollection 2023.

Abstract

Background: Acupuncture has unique advantages in the treatment of low back fasciitis and has been paid increasing attention. At present, many studies have summarized the efficacy of acupuncture and moxibustion in the treatment of low back fasciitis, but few have been summarized from the perspective of acupuncture alone.

Aim: To evaluate the clinical efficacy of acupuncture in the treatment of lumbodorsal fasciitis by meta-analysis.

Methods: The randomized controlled trials (RCT) of acupuncture in the treatment of low back fasciitis were searched in Pubmed, Embase, and Cochrane Library from the data of establishment to July 2023. Two authors independently conducted document screening, data abstraction, and qualitative assessment. RevMan 5.3 software and Stata 17.0 software were used for data analysis. The quantitative data were represented by mean difference (MD). The qualitative data were represented by odds ratio (OR).

Results: Finally, a total of 12 RCTs with a total sample size of 930 cases were included, of which 461 patients received simple acupuncture treatment (Group A) and 469 patients received non-simple acupuncture treatment (Group B). The results of the meta-analysis showed that: (1) Clinical total effective rate: The results of subgroup analysis showed that the clinical total effective rate of acupuncture was significantly higher than that of Western medicine [OR = 12.72, 95% CI (2.26, 71.78), P = 0.004]; the total effective rate of the traditional Chinese medicine therapy was significantly higher than that of acupuncture [OR = 0.35, 95% CI (0.19, 0.65), P < 0.001]. (2) Score of the visual analog scale (VAS) after treatment: There was no significant difference in VAS score between Group A and Group B after treatment [MD = -0.22, 95% CI (-1.56, 1.12), P = 0.75]. (3) Oswestry disability index after treatment: The results of subgroup analysis showed that the Oswestry disability index after treatment of acupuncture was significantly lower than that of Western medicine therapy [MD = -0.05, 95% CI (-0.10, -0.00), P = 0.04]; the Oswestry disability index of Chinese medicine therapy was significantly lower than that of acupuncture alone [WD = 0.10, 95% CI (0.05, 0.15), P < 0.001].

Conclusion: In the treatment of low back fasciitis, simple acupuncture therapy is superior to Western medicine therapy in improving treatment efficiency and low back muscle dysfunction, but slightly inferior to other traditional Chinese medicine therapies. Due to the limited efficacy of acupuncture, it is recommended to combine other therapies to improve the efficacy. Due to the small number of RTCs included and the unclear evaluation of many bias risks, high-quality, large sample randomized controlled studies are still needed to prove it.

Keywords: Low back fasciitis; acupuncture; meta-analysis; randomized controlled trials; system evaluation; treatment effect.

Publication types

  • Review