Meta-analysis and Trial Sequential Analysis for Therapeutic Eefficacy and Safety of Acupotomy and Acupuncture for Cervical Spondylotic Radiculopathy
Objective:To compare the therapeutic efficacy and safety between acupotomy and acupuncture for cervical spondylotic radiculopathy patients, to provide evidence for clinical practice.Methods:To search in the database, such as PubMed, Cochrane, China Biomedical Literature Database(CBM), China Knowledg...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Editorial Office of Rehabilitation Medicine
2019-02-01
|
| Series: | 康复学报 |
| Subjects: | |
| Online Access: | http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.J1329.2019.01063 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841537032311013376 |
|---|---|
| author | Renpan ZHANG Zhongbiao XIU Jing LIU Bin CHEN Hong LIU Hongjia ZHAO |
| author_facet | Renpan ZHANG Zhongbiao XIU Jing LIU Bin CHEN Hong LIU Hongjia ZHAO |
| author_sort | Renpan ZHANG |
| collection | DOAJ |
| description | Objective:To compare the therapeutic efficacy and safety between acupotomy and acupuncture for cervical spondylotic radiculopathy patients, to provide evidence for clinical practice.Methods:To search in the database, such as PubMed, Cochrane, China Biomedical Literature Database(CBM), China Knowledge Network Database(CNKI), Chinese Scientific Journal Database(VIP)and Wanfang Database. Clinical randomized controlled trials(RCTs)of acupotomy versus acupuncture with/without additional treatment for cervical spondylotic radiculopathy patients would be searched by two reachers independently. The time limitation was from the commencement of each database to 31st October 2018. The total effective rate and curative rate would be assessed as the primary outcomes. Visual analogue scale and clinical symptom score would be assessed as the secondary outcome. After selected, the included data were analyzed by Review Manager 5.3 software for meta-analysis and TSA V 0.9 software for trial sequential analysis(TSA).If <italic>P</italic>≤0.1 of 2 test or <italic>I</italic><sup>2</sup>>50%indicated statistically significant heterogeneity, a random-effect model would be used. Otherwise, we would calculate using a fixed effects model. Continuous outcomes would be presented as the mean difference(MD)with 95% confidence interval(<italic>CI</italic>), while dichotomous data would be presented as relative risk(<italic>RR</italic>)with 95% <italic>CI</italic>.Results:A total of 10 RCT trials involving 727 patients were eventually included. The meta-analyses demonstrated that the total effective rate of the acupotomy group was significantly higher than that of the acupuncture group [<italic>RR</italic>=1.09,95% <italic>CI</italic>(1.04,1.14),<italic>P</italic>=0.0 006<0.005],and TSA results showed that the cumulative <italic>Z</italic>-values confirmed the results of meta-analysis through traditional boundary value and TSA threshold. The curative rate of acupotomy group was higher than that of acupuncture group [<italic>RR</italic>=1.54,95%<italic>CI</italic>(1.27,1.87),<italic>P</italic><0.0 001],and TSA results showed that the cumulative Z-values confirmed the results of meta-analysis through traditional boundary value and TSA threshold. The VAS score [<italic>MD</italic>=-0.70,95%<italic>CI</italic>(-0.97,-0.43),<italic>P</italic><0.00 001] and clinical symptom score [<italic>MD</italic>=1.20,95%<italic>CI</italic>(0.69,1.72),<italic>P</italic><0.00 001] after treatment had statistical significance between acupotomy group and acupuncture group.Conclusion:Acupotomy is more effective than acupuncture in the treatment of cervical spondylotic radiculopathy. However, due to low quality and limited sample size of included studies, further well-designed RCTs with high quality are still needed to evaluate the beneficial effects of acupotomy. |
| format | Article |
| id | doaj-art-6bba961016f548f49ec5c5ea5974037b |
| institution | Kabale University |
| issn | 2096-0328 |
| language | English |
| publishDate | 2019-02-01 |
| publisher | Editorial Office of Rehabilitation Medicine |
| record_format | Article |
| series | 康复学报 |
| spelling | doaj-art-6bba961016f548f49ec5c5ea5974037b2025-01-14T10:04:43ZengEditorial Office of Rehabilitation Medicine康复学报2096-03282019-02-0129636923128795Meta-analysis and Trial Sequential Analysis for Therapeutic Eefficacy and Safety of Acupotomy and Acupuncture for Cervical Spondylotic RadiculopathyRenpan ZHANGZhongbiao XIUJing LIUBin CHENHong LIUHongjia ZHAOObjective:To compare the therapeutic efficacy and safety between acupotomy and acupuncture for cervical spondylotic radiculopathy patients, to provide evidence for clinical practice.Methods:To search in the database, such as PubMed, Cochrane, China Biomedical Literature Database(CBM), China Knowledge Network Database(CNKI), Chinese Scientific Journal Database(VIP)and Wanfang Database. Clinical randomized controlled trials(RCTs)of acupotomy versus acupuncture with/without additional treatment for cervical spondylotic radiculopathy patients would be searched by two reachers independently. The time limitation was from the commencement of each database to 31st October 2018. The total effective rate and curative rate would be assessed as the primary outcomes. Visual analogue scale and clinical symptom score would be assessed as the secondary outcome. After selected, the included data were analyzed by Review Manager 5.3 software for meta-analysis and TSA V 0.9 software for trial sequential analysis(TSA).If <italic>P</italic>≤0.1 of 2 test or <italic>I</italic><sup>2</sup>>50%indicated statistically significant heterogeneity, a random-effect model would be used. Otherwise, we would calculate using a fixed effects model. Continuous outcomes would be presented as the mean difference(MD)with 95% confidence interval(<italic>CI</italic>), while dichotomous data would be presented as relative risk(<italic>RR</italic>)with 95% <italic>CI</italic>.Results:A total of 10 RCT trials involving 727 patients were eventually included. The meta-analyses demonstrated that the total effective rate of the acupotomy group was significantly higher than that of the acupuncture group [<italic>RR</italic>=1.09,95% <italic>CI</italic>(1.04,1.14),<italic>P</italic>=0.0 006<0.005],and TSA results showed that the cumulative <italic>Z</italic>-values confirmed the results of meta-analysis through traditional boundary value and TSA threshold. The curative rate of acupotomy group was higher than that of acupuncture group [<italic>RR</italic>=1.54,95%<italic>CI</italic>(1.27,1.87),<italic>P</italic><0.0 001],and TSA results showed that the cumulative Z-values confirmed the results of meta-analysis through traditional boundary value and TSA threshold. The VAS score [<italic>MD</italic>=-0.70,95%<italic>CI</italic>(-0.97,-0.43),<italic>P</italic><0.00 001] and clinical symptom score [<italic>MD</italic>=1.20,95%<italic>CI</italic>(0.69,1.72),<italic>P</italic><0.00 001] after treatment had statistical significance between acupotomy group and acupuncture group.Conclusion:Acupotomy is more effective than acupuncture in the treatment of cervical spondylotic radiculopathy. However, due to low quality and limited sample size of included studies, further well-designed RCTs with high quality are still needed to evaluate the beneficial effects of acupotomy.http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.J1329.2019.01063cervical spondylotic radiculopathyacupotomyacupunctureMeta-analysistrial sequential analysis |
| spellingShingle | Renpan ZHANG Zhongbiao XIU Jing LIU Bin CHEN Hong LIU Hongjia ZHAO Meta-analysis and Trial Sequential Analysis for Therapeutic Eefficacy and Safety of Acupotomy and Acupuncture for Cervical Spondylotic Radiculopathy 康复学报 cervical spondylotic radiculopathy acupotomy acupuncture Meta-analysis trial sequential analysis |
| title | Meta-analysis and Trial Sequential Analysis for Therapeutic Eefficacy and Safety of Acupotomy and Acupuncture for Cervical Spondylotic Radiculopathy |
| title_full | Meta-analysis and Trial Sequential Analysis for Therapeutic Eefficacy and Safety of Acupotomy and Acupuncture for Cervical Spondylotic Radiculopathy |
| title_fullStr | Meta-analysis and Trial Sequential Analysis for Therapeutic Eefficacy and Safety of Acupotomy and Acupuncture for Cervical Spondylotic Radiculopathy |
| title_full_unstemmed | Meta-analysis and Trial Sequential Analysis for Therapeutic Eefficacy and Safety of Acupotomy and Acupuncture for Cervical Spondylotic Radiculopathy |
| title_short | Meta-analysis and Trial Sequential Analysis for Therapeutic Eefficacy and Safety of Acupotomy and Acupuncture for Cervical Spondylotic Radiculopathy |
| title_sort | meta analysis and trial sequential analysis for therapeutic eefficacy and safety of acupotomy and acupuncture for cervical spondylotic radiculopathy |
| topic | cervical spondylotic radiculopathy acupotomy acupuncture Meta-analysis trial sequential analysis |
| url | http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.J1329.2019.01063 |
| work_keys_str_mv | AT renpanzhang metaanalysisandtrialsequentialanalysisfortherapeuticeefficacyandsafetyofacupotomyandacupunctureforcervicalspondyloticradiculopathy AT zhongbiaoxiu metaanalysisandtrialsequentialanalysisfortherapeuticeefficacyandsafetyofacupotomyandacupunctureforcervicalspondyloticradiculopathy AT jingliu metaanalysisandtrialsequentialanalysisfortherapeuticeefficacyandsafetyofacupotomyandacupunctureforcervicalspondyloticradiculopathy AT binchen metaanalysisandtrialsequentialanalysisfortherapeuticeefficacyandsafetyofacupotomyandacupunctureforcervicalspondyloticradiculopathy AT hongliu metaanalysisandtrialsequentialanalysisfortherapeuticeefficacyandsafetyofacupotomyandacupunctureforcervicalspondyloticradiculopathy AT hongjiazhao metaanalysisandtrialsequentialanalysisfortherapeuticeefficacyandsafetyofacupotomyandacupunctureforcervicalspondyloticradiculopathy |