| Purpose: Evaluate the clinical efficacy on treating KOA by acupuncture.Method: Extract searching keywords and design scientific,effective information retrieval strategy.We searched CNKI,CBM,WF and VIP for RCTs until December 2016.This study contained forty RCTs,including 4031 patients.2012 patients were in experimental group and 2019 ones were in control group.Rev Man 5.3 software was used for data analyses.The risk of bias was evaluated by the Cochrane Collaboration’s tool.The main outcomes included clinical efficiency,pain effect,stiff effect and daily-life knee mobility.These outcomes were estimated by OR,SMD and 95%CI.Results:1.Treating KOA by acupuncture: experimental group was better than control group in global clinical efficiency [OR=3.20,95%CI(2.63,3.90)];experimental group was lower than control group in global pain effect [SMD=-0.52,95%CI(-0.90,-0.15)];there was no significant difference between two groups in stiff effect [SMD=-0.22,95%CI(-0.52,0.08)];there was no significant difference between two groups in daily-life knee mobility;Each funnel plot was approximately symmetrical.2.The clinical efficiency of treating KOA by three different methods: OR(needle warming moxibustion)>OR(common needling)>OR(electroacupucture);pain effect: SMD(needle warming moxibustion)<SMD(electroacupucture)<SMD(common needling);stiff effect: SMD(electroacupucture)<SMD(needle warming moxibustion)<SMD(common needling);daily-life knee mobility: SMD(needle warming moxibustion)<SMD(electroacupucture)<SMD(common needling).3.The clinical efficiency of treating KOA by acupuncture compared with by traditional Chinese medicine,massage and Western medicine: OR(vs Western medicine)>OR(vs traditional Chinese medicine)>OR(vs massage);pain effect: SMD(vs Western medicine)<SMD(vs traditional Chinese medicine)<SMD(vs massage);stiff effect: SMD(vs Western medicine)<SMD(vs traditional Chinese medicine)<SMD(vs massage);daily-life knee mobility: SMD(vs Western medicine)<SMD(vs traditional Chinese medicine)<SMD(vs massage).4.The clinical efficiency of treating KOA by acupuncture in different ending time: OR(more than 30d)>OR(22d~30d)>OR(1d~21d);pain effect: SMD(more than 30d)<SMD(1d~21d)<SMD(22d~30d);stiff effect: SMD(more than 30d)<SMD(22d~30d)<SMD(1d~21d);daily-life knee mobility: SMD(more than 30d)<SMD(1d~21d)<SMD(22d~30d).5.The clinical efficiency of treating KOA by acupuncture plus physiotherapy compared with by physiotherapy only: experimental group was better than control group [OR=2.50,95%CI(1.28,4.88)];the clinical efficiency of treating KOA by acupuncture plus massage compared with by massage only: experimental group was better than control group [OR=4.77,95%CI(2.85,7.98)];the clinical efficiency of treating KOA by acupuncture plus traditional Chinese medicine compared with by traditional Chinese medicine only: experimental group was better than control group [OR=5.05,95%CI(2.55,9.98)].Conclusion:1.The clinical efficiency and relieving pain effect of treating KOA by acupuncture were better than other therapies.2.Treating KOA by three different methods: the clinical efficiency,relieving pain effect and improving daily-life knee mobility of needle warming moxibustion were the best;improving stiff effect of electroacupucture was the best.3.Treating KOA by acupuncture compared with by traditional Chinese medicine,massage and Western medicine: the clinical efficiency,relieving pain effect,improving stiff effect and improving daily-life knee mobility of comparing with Western medicine were the best.4.Treating KOA by acupuncture in different ending time: the clinical efficiency,relieving pain effect,improving stiff effect and improving daily-life knee mobility of more than 30 days were the best.5.The clinical efficiency of treating KOA: acupuncture plus physiotherapy was better than physiotherapy only;acupuncture plus massage was better than massage only;acupuncture plus traditional Chinese medicine was better than traditional Chinese medicine only. |
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