The Systematic Review To Compare Acupuncture And Tuina Against Traction For Lumbar Interverlebral Disc Herniation

Objective: The objective of this systemic review(SR)evaluates all randomized controlled trials(RCTs)and quasi-randomized controlled trials(Q-RCTs)to assess and compare the clinical effects and safety of acupuncture treatment for Lumbar Intervertebral Disc herniation(LIDH).Methods: First,using various worldwide databases,we researched kind of literature in English and Chinese from the Medline/PubMed,EMBASE,the Cochrane Library,CNKI,Wanfang data and VIP databases.Next,two reviewers screened the articles strictly in accordance with the inclusion and exclusion criteria and then evaluated the quality of articles independently.Then,using Review Manager 5.3 program to proceed with meta-analysis,to determine the clinical effective rate,and to consider the adverse effect for each clinical trial.Lastly,GRADE profiler software used to rate the quality evidence of results.Results: Six case studies include of which five articles grade “B” for methodological quality,and another one article grades.The most sequent of evidence quality is “low”,some article evaluate to “moderate” or “very low”.Meta-analysis:(1)the clinical effective rate: acupuncture combined with massage is better than conventional traction therapy(RR=1.29,95%CI=[1.15,1.44],P<0.00001);acupuncture combined with massage and traditional Chinese medicine is better than conventional traction therapy(RR=5.80,95%CI=[1.59,1.88],P<0.00001).(2)safety: the results of this systematic review did not report adverse effects of acupuncture and massage and traction therapy.In fact,lack of adverse reaction data,it is impossible to objectively evaluate the safety of acupuncture and moxibustion therapy and traction therapy in the treatment of lumbar disc herniation.Conclusion: First,acupuncture and massage therapy improve the total effective rate of lumbar disc herniation more than traction therapy,acupuncture and massage therapy are better,but the reliability of this argument needs more research to further verify.Second,lack of adverse reaction data,it is impossible to objectively evaluate the safety of acupuncture and moxibustion in the treatment of lumbar disc herniation.In addition,acupuncture and massage treatment of lumbar disc herniation,although there are certain advantages in the outcome indicators,but does not rule out the future of high-quality clinical trials to obtain new results.