Meta-analysis of the effect of acupoint injection on pain improvement and joint function in patients with knee osteoarthritis / 中国组织工程研究

ABSTRACT

BACKGROUND: A large number of clinical research data show that acupoint injection has the advantages of good therapeutic effect and few adverse reactions in the treatment of knee osteoarthritis, but there is a lack of related multicenter and large-sample clinical trial. OBJECTIVE: To evaluate the effect of acupoint injection on the pain improvement and joint function in patients with knee osteoarthritis by meta-analysis. METHODS: CNKI, Wanfang, VIP, CBM, PubMed, Embase and Cochrane Library databases were searched for the randomized controlled trials concerning the acupoint injection for treating knee osteoarthritis published before May 2019. The observation group was acupoint injection or acupoint injection combined with other treatments. The control group was the treatments different from acupoint injection. The language was either in Chinese or English. After screening, the data included in the study were extracted by Review Manager 5.3 software for meta-analysis. RESULTS AND CONCLUSION: (1) Sixteen randomized controlled trials were included, involving 1 287 patients (648 cases in the observation group, and 639 cases in the control group). (2) Meta-analysis results showed that the overall effective rate, cure rate, Lysholm score and Japanese Orthopaedic Association scores in the observation group were significantly higher than those in the control group [OR=3.23, 95%CI (2.19, 4.76), Z=5.91, P < 0.000 01; OR=1.86, 95%CI (1.35, 2.58), Z=3.74, P=0.000 2; MD=7.87, 95%CI (2.66, 13.08), Z=2.96, P=0.003; MD=9.16, 95%CI (4.18, 14.13), Z=3.61, P=0.000 3]. The Visual Analogue Scale score, WOMAC score, Lequesne index score, and the incidence of adverse reactions between two groups showed no significant difference [MD=-1.11, 95%CI (-2.29, 0.07), Z=1.84, P=0.07; MD=-7.56, 95%CI (-17.26, 2.14), Z=1.53, P=0.13; MD=-0.46, 95%C I(-1.62, 0.71), Z=0.77, P=0.44; OR=1.31, 95%CI (0.31, 5.57), Z=0.37, P=0.71]. (3) These results indicate that the efficacy of acupoint injection for treating knee osteoarthritis is accurate. Because the literature quality included in the study is not high and bias may exist, more high-quality randomized controlled trials are still needed to verify the conclusions.