| Objective: Ankylosing spondylitis(AS)is an autoimmune disease characterized by low back pain,stiffness and limited movement.At present,there are many clinical methods for the treatment of AS,but no radical cure has been studied.AS an important traditional therapy of traditional Chinese medicine,acupuncture has obvious curative effect and is widely used in the treatment of AS.The purpose of this study was to systematically evaluate the clinical efficacy and safety of routine acupuncture in the treatment of ankylosing spondylitis.Methods: Using computer to retrieve CNKI,Wanfang,VIP,CBM,Pubmed,EMbase and Cochrane database,such AS time limit for from building to October 2019,collection of routine acupuncture treatment AS clinical randomized controlled trials.The bias risk assessment tool of Cochrane was used to assess the risk of included literature,and the RevMen5.3 software provided by the Cochrane collaboration was used for Meta analysis,and forest maps and funnel maps were made.Results: A total of 1479 patients were included in 18 studies,including 750 in the observation group and 729 in the control group.1.Total effective rate was used as the efficacy criterion in 14 studies,which were divided into two subgroups according to the intervention measures.There was a statistical difference in total effective rate between the observation group and the control group in group 1 [OR=3.63,95%CI(2.92,6.33),P<0.00001],and there was a statistical difference in total effective rate between the observation group and the control group in group 2 [OR=5.80,95%CI(3.44,9.79),P<0.00001].2.There were 5 studies using CRP as the efficacy standard,and the results of Meta analysis were [MD=-20.58,95%CI(-37.23,-3.94),P=0.02],suggesting that the difference between the two groups was statistically significant.3.There were 4 studies using ESR as the efficacy standard,and the results of meta-analysis were [MD=-13.82,95%CI(-22.58,-5.05),P=0.002],suggesting that the difference between the two groups was statistically significant.4.There were 3 studies using BASDAI as the efficacy criterion,and the results of meta-analysis were [MD=-4.89,95%CI(-10.20,0.41),P=0.07],suggesting that there was no statistically significant difference between the two groups.5.There were 3 studies using BASFI as the efficacy standard,and the results of meta-analysis were [MD=-4.09,95%CI(-7.51,-0.67),P=0.02],suggesting that the difference between the two groups was statistically significant.6.There were 3 studies using Schober test as the efficacy standard,and the results of meta analysis were [MD=1.33,95%CI(-1.10,3.77),P=0.28],suggesting that there was no statistically significant difference between the two groups.7.There were 5 studies using thoracic expansion degree as the efficacy criterion,and the results of Meta analysis were [MD=0.04,95%CI(0.04,0.82),P=0.03],suggesting that the difference between the two groups was statistically significant.8.Three studies mentioned using finger ground distance as the efficacy criterion,and the results of meta-analysis [MD=-5.70,95%CI(-10.40,-1.00),P=0.02] showed statistically significant differences between the two groups.9.There were 4 studies using recurrence rate as the efficacy criterion,and the results of meta-analysis showed that [OR=0.46,95%CI(0.26,0.84),P=0.01],suggesting that the difference between the two groups was statistically significant.Conclusion: According to the results of this meta-analysis,acupuncture treatment of AS has obvious clinical effect,good safety and fewer adverse reactions.Acupuncture can improve the clinical efficiency,reduce CRP and ESR,and improve the body's motor function.However,there is a high possibility of selection bias and publication bias in the included literatures in this study,and the quality is relatively low.Therefore,if the efficacy of acupuncture in the treatment of AS needs to be further studied,more rigorous experimental design and implementation means should be adopted,and a large sample size and multi-center randomized controlled trial should be conducted. |
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