Meta-analysis Of Acupuncture Therapy For Knee Osteoarthritis

Objective:To evaluate the clinical curative effects of acupotomology therapy in treatment of knee osteoarthritis(KOA).Methods:All the randomized controlled trial(RCT)articles about acupotomology therapy for treatment of KOA included from database establishing to December 31,2020 were retrieved from WanFang Database,China national knowledge internet,VIP Database,PubMed and The Cochrane Library through computer.The logical combination off“针刀”“小针刀”“膝骨关节炎”“膝骨性关节炎”and“膝关节骨性关节炎”were used as Chinese index terms,and the logical combination of small needle knife,needle knife and knee osteoarthritis as the English index terms.The interventions were conventional acupotomology therapy in acupotomology group and conventional acupuncture therapy in acupuncture group,and other same basic therapies could be used in the 2 groups.The articles were retrieved and screened and the data of included articles were extracted.The methodological quality of research in the articles was evaluated by using Cochrane risk bias assessment tools,and a Meta-analysis was conducted by using Review Manager 5.4.1 software.Results:Twenty Chinese articles(2068 patients)were included in the final analysis,1035 patients in acupotomology group and 1033 patients in acupuncture group.The results of Meta-analysis demonstrated that the effective rate was higher in acupotomology group compared to acupuncture group(χ2=11.920,P=0.610,I2=0%,RR=1.16,95%CI(1.11,1.22),P=0.000).The results of subgroup analysis demonstrated that the effective rate was higher in acupotomology group compared to acupuncture group in the articles about evaluation of therapeutic efficiency according to Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes and Guiding principles of clinical research on new Chinese medicine(χ2=6.440,P=0.3 80,I2=7%,RR=1.17,95%CI(1.08,1.26),P=0.000;χ2=5.420,P=0.61 0,I2=0%,RR=1.16,95%CI(1.09,1.23),P=0.000).The posttreatment pain visual analogue scale(VAS)scores were lower in acupotomology group compared to acupuncture group(χ2=94.340,P=0.00,I2=89%,MD=-1.24,95%CI(-1.58,-0.90),P=0.000).The posttreatment Western Ontario and McMaster Universities(WOMAC)osteoarthritis index was lower in acupotomology group compared to acupuncture group(χ2=42.690,P=0.000,I2=88%,MD=-9.06,95%CI(-13.34,-4.78),P=0.000).Publication bias was analyzed according to the effective rate,and the results showed that the funnel-plot was not completely symmetric,which suggested the presence of publication bias,at least,it cannot be ruled out that possibility.Conclusion:Available evidences suggest that acupotomology therapy is an effective method for treatment of KOA,and it surpasses acupuncture therapy in clinical curative effects.Due to the poor quality of the included articles and the heterogeneity among the included articles,the obtained conclusions need to be confirmed by further studies.