Network meta-analysis on effectiveness of fire needle, warm acupuncture, and electroacupuncture in the treatment of knee osteoarthritis / 中国组织工程研究

ABSTRACT

BACKGROUND: Acupuncture has different forms as a kind of therapy, mainly warm acupuncture, fire needle and electroacupuncture, but the balance of effectiveness and safety between these measures remains unclear. OBJECTIVE: To compare the effectiveness of warm acupuncture, fire needle and electroacupuncture in the intervention of knee osteoarthritis by network meta-analysis. METHODS: The Embase, Cochrane Library, PubMed, CNKI, Wanfang, VIP and CBMdisc databases were searched for the clinical randomized controlled trials of warm acupuncture, fire needle and electroacupuncture in the treatment of knee osteoarthritis published before September 20, 2019. RevMan 5.3 and Stata 14.0 were used for data analysis. RESULTS AND CONCLUSION: A total of 2 871 patients with knee osteoarthritis were included in 34 randomized controlled trials. The results of meta-analysis showed that (1) the total clinical effective rate in the fire needle group (OR=1.08, 95%CI 1.00-1.17, P < 0.05) and warm acupuncture group (OR=1.08, 95%CI 1.02-1.14, P < 0.05) was better than that in the electroacupuncture, and the total effective rate of the three acupuncture treatments was better than that of western medicine, especially fire needle. (2) In the aspect of improving the Visual Analogue Scale scores, the fire needle (MD=-2.12, 95%CI -3.52 to -0.71, P < 0.05), warm acupuncture (MD=-1.31, 95%CI -2.33 to -0.29, P < 0.05), and electroacupuncture (MD=-1.17, 95%CI -2.19 to -0.16), P < 0.05) were superior to western medicine, especially fire needle. (3) In terms of reducing WOMAC scores, fire needle (MD=-15.38, 95%CI -27.88 to -2.87, P < 0.05), warm acupuncture (MD=-11.48, 95%CI -16.45 to -6.51, P < 0.05), and electroacupuncture (MD=-7.29, 95%CI -11.86 to -2.72, P < 0.05) were superior to western medicine, especially fire needle. (4) In summary, comprehensive comparison of three kinds of acupuncture, in the treatment of knee osteoarthritis, fire needle is the first choice. However, it still needs to be confirmed by more high-quality randomized controlled trials.