The Systematic Review Of "Acupuncture With Exercise Therapy " For Treating The Disease Of Acute Lumbar Sprain

Objectives:To collect randomized controlled trials (RCTs) and quasi-randomized controlled trials (Q-RCTs) about the "acupuncture with exercise therapy" (AET) to treat the disease of acute lumbar sprain (ALS) and to evaluate the efficacy and safety of this therapy for the disease in this systematic review (SR).Methods:We searched the literature from English/Chinese databases as the Medline/PubMed, EMBASE, the Cochrane Library, CNKI, CBM and VIP according to the search strategy combined with hand retrieval and searching the Internet of Google Scholar. Two researchers screened the articles strictly in accordance with the inclusion and exclusion criteria, and then evaluated the quality of articles independently. The two reviewers reached consensus through discussion or a third researcher arbitrated the problem if the conclusion was inconsistent. Clinical effective rate, one-off cure rate, visual analogue scale (VAS), Roland-Morris Disability Questionnaire score and the side-effect were chosen as outcomes. The result pooled by RevMan5.2 software and evidence quality of outcomes was rating by GRADE profiler software.Results:Seventeen Chinese articles were included finally. Three articles were graded to level "A" for methodological quality,12 were categorized as level "B", the rest were defined "C". Most outcomes were rated "low" for evidence quality, while a few were assessed "moderate" or "very low". Meta analysis:(1) The clinical effective rate: ①AET was superior to normal local acupuncture method for treating acute lumbar sprain (OR=7.18,95%CI=[3.77,13.65]), but there was not enough strong evidence to prove that AET was superior to western medicine.②AET combined with other method was better than normal local acupuncture method (OR=7.66,95%CI=[2.54, 23.10]) and superior to western medicine (OR=5.45,95%CI=[2.21,13.43]). (2) One-off cure rate:①AET was more and more effective than the normal local acupuncture method (OR=7.12,95% CI=[4.06,12.51) and the western medicine (OR=5.23,95% CI=[1.66,16.51]).②AET combined with other method was superior to normal local acupuncture method (OR=5.21,95%CI=[2.78,9.78]) and better than the western medicine (OR=3.37,95%CI=[1.82,6.26]). (3) VAS:AET had showed an advantage over the local acupuncture method (MD=-1.71,95%CI=[-1.87,-1.55]) and the western medicine (MD=-1.90,95%CI=[-2.53,-1.27]), but there is not enough evidence to prove that AET combined with other method was better than the western medicine.(4) RDQ:AET dominated the normal local acupuncture (MD=-1.87, 95%CI=[-3.15,-0.59]) and the western medicine (MD=-1.61,95%CI=[-2.28,-0.94]). There were 3 documents reporting safety events, yet there was no severe adverse events related to the test, so we deemed that the security was relatively high.Conclusion:The short-term efficacy of AET is better than the normal local acupuncture method, but not enough evidence has been found on its superior about that the long-term effect. The safety is relatively satisfactory according to included articles. The methodological quality of primary studies and the evidence quality of pooled outcomes in this SR are relatively low. There is lack of high quality RCT to support the conclusion and long-term curative effect of the report In the future, more high-quality studies are warranted to confirm its effectiveness.