A Randomized Clinical Study on Acupuncture Therapy for Relieving Sciatica Caused by Lumbar Disc Herniation

Li, Cheng; Li, Tianqiang; Ma, Xiaobo; Ni, Chenfei; Wei, Xiaoli; Zhang, Shinian

doi:10.36468/pharmaceutical-sciences.spl.284

Cited by 3 publications

(26 citation statements)

References 18 publications

(21 reference statements)

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“…Among these, 1,180 records were excluded, and the remaining 451 records required a full-text assessment. Through screening, we finally included 30 studies (Chen et al, 2005 ; Li and Meng, 2011 ; Jiang, 2012 , 2018 ; Liu, 2012 , 2015 , 2017 ; Zeng and Liao, 2012 ; Zhai, 2012 ; Zhang, 2012 ; Shang et al, 2014 ; Ai, 2015 ; Huang et al, 2015 , 2019 ; Nie, 2015 ; Ye et al, 2015 ; Li and Kang, 2016 ; Wang, 2016 , 2017 , 2020 ; Wei, 2016 ; Hu, 2017 ; Yu, 2017 ; Zou, 2017 ; Li, 2018 ; Zheng, 2019 ; Gu, 2020 ; Huo, 2020 ; Li et al, 2021 ). A total of 421 studies were excluded after screening the full text.…”

Section: Resultsmentioning

confidence: 99%

“…This review included 30 studies with 2,662 participants in total. Almost all studies were conducted in China, whereas two articles (Huang et al, 2019 ; Li et al, 2021 ) were English publications. The sample sizes ranged from 30 to 310 participants per study.…”

Section: Resultsmentioning

confidence: 99%

“…The sample sizes ranged from 30 to 310 participants per study. The gender information on participants showed that the male-to-female ratio of the acupuncture group (AG) was 1.36 (575/423) and the male-to-female ratio of the control group was 1.43 (573/402), which were identified from 22 studies (Chen et al, 2005 ; Zhai, 2012 ; Shang et al, 2014 ; Ai, 2015 ; Huang et al, 2015 , 2019 ; Liu, 2015 , 2017 ; Ye et al, 2015 ; Li and Kang, 2016 ; Wang, 2016 , 2017 , 2020 ; Wei, 2016 ; Hu, 2017 ; Zou, 2017 ; Jiang, 2018 ; Li, 2018 ; Li et al, 2019 , 2021 ; Zheng, 2019 ; Huo, 2020 ). All participants in the included trials must be diagnosed with sciatica.…”

Section: Resultsmentioning

confidence: 99%

“…The results of the VAS score in the acupuncture group showed a statistically significantly lower value than that in the MT group (MD = −1.77, 95%CI [−1.89, −1.66], P < 0.00001) (Figure 5). In addition, two studies (Huang et al, 2019;Li et al, 2021) reported that real acupuncture was statistically superior to SA in improving the VAS score for sciatic pain (MD = −1.13, 95%CI [-1.66, −0.60], P < 0.0001) (Figure 5), and there was no evidence of heterogeneity (P = 1.00, I 2 = 0%). The subgroup analysis indicated that both MA (SMD = −3.16, 95%CI [−4.48, −1.83]) and EA (SMD=-0.50, 95%CI [−0.89, −0.12]) reduced the VAS score more than MT.…”

Section: Pain Intensitymentioning

confidence: 99%

“…The total effective rate was reported in 26 studies (Chen et al, 2005;Li and Meng, 2011;Jiang, 2012Jiang, , 2018Zeng and Liao, 2012;Zhai, 2012;Zhang, 2012;Shang et al, 2014;Ai, 2015;Huang et al, 2015;Liu, 2015Liu, , 2017Nie, 2015;Li and Kang, 2016;Wang, 2016Wang, , 2017Wang, , 2020Wei, 2016;Hu, 2017;Yu, 2017;Zou, 2017;Li, 2018;Li et al, 2019;Zheng, 2019;Gu, 2020;Huo, 2020) in which the efficacy of acupuncture therapy was compared with that of MT on sciatica.…”

Section: E Ects Of Interventions Primary Outcomes Total E Ective Ratementioning

confidence: 99%

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The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails

Zhang

Hu²,

Huang³

et al. 2023

Front. Neurosci.

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Background and objectiveSciatica is a common type of neuropathic pain disease which poses a huge financial burden to the patient. For patients with sciatica, acupuncture has been recommended as an effective method for pain relief, while there is currently a lack of sufficient evidence to support its efficacy and safety. In this review, we aimed to critically assess the published clinical evidence on the efficacy and safety of acupuncture therapy for treating sciatica.MethodsAn extensive literature search strategy was established in seven databases from their inception to 31 March 2022. Two independent reviewers performed the literature search, identification, and screening. Data extraction was performed on studies that meet the inclusion criteria, and a further quality assessment was performed according to the Cochrane Handbook and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) recommendations. Summary Risk ratio (RR) and standardized mean differences (SMDs) with 95% confidence interval (CI) were calculated using the fixed-effects or the random-effects model. Heterogeneity in effect size across studies was explored using the subgroup analysis and the sensitivity analysis. The quality of evidence was estimated following the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.ResultsA total of 30 randomized controlled trials (RCTs) involving 2,662 participants were included in the meta-analysis. The results of the integration of clinical outcomes showed that the clinical efficacy of acupuncture was superior to that of medicine treatment (MT) in improving the total effective rate (relative risk (RR) = 1.25, 95% confidence interval (CI) [1.21, 1.30]; moderate certainty of evidence), reducing the Visual Analog Scale (VAS) pain score (standardized mean difference (SMD) = −1.72, 95% CI [-2.61, −0.84]; very low certainty of evidence), increasing pain threshold (SMD = 2.07, 95% CI [1.38, 2.75]; very low certainty of evidence), and decreasing recurrence rate (RR = 0.27, 95% CI [0.13, 0.56]; low certainty of evidence). In addition, a few adverse events (RR = 0.38, 95% CI [0.19, 0.72]; moderate certainty of evidence) were reported during the intervention, which indicated that acupuncture was a safe treatment option.ConclusionsAcupuncture therapy is an effective and safe treatment for patients with sciatica, and it can be considered a suitable replacement for medicine treatment (MT). However, given the high heterogeneity and a low methodological quality of previous studies, future RCTs should be well-designed according to the rigorous methodology.Systematic review registrationInternational Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) (https://inplasy.com/register/), identifier [INPLASY202240060].

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Pain Intensitymentioning

confidence: 99%

Section: E Ects Of Interventions Primary Outcomes Total E Ective Ratementioning

confidence: 99%

See 3 more Smart Citations

The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails

Zhang

Hu²,

Huang³

et al. 2023

Front. Neurosci.

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An evidence‐based guideline on treating lumbar disc herniation with traditional Chinese medicine

Qin,

Sun,

et al. 2024

J Evidence Based Medicine

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BackgroundLumbar disc herniation (LDH), as one of the most common causes of lower back pain, imposes a heavy economic burden on patients and society. Conservative management is the first‐line choice for the majority of LDH patients. Traditional Chinese medicine (TCM) is an important part of conservative treatment and has attracted more and more international attention.Study designEvidence‐based guideline.MethodsWe formed a guideline panel of multidisciplinary experts. The clinical questions were identified on the basis of a systematic literature search and a consensus meeting. We searched the literature for direct evidence on the management of LDH and assessed its certainty‐generated recommendations using the grading of recommendations, assessment, development, and evaluation (GRADE) approach.ResultsThe guideline panel made 20 recommendations, which covered the use of Shentong Zhuyu decoction, Shenzhuo decoction, Simiao San decoction, Duhuo Jisheng decoction, Yaobitong capsule, Yaotongning capsule, Osteoking, manual therapy, needle knife, manual acupuncture, electroacupuncture, Chinese exercise techniques (Tai Chi, Baduanjin, or Yijinjing), and integrative medicine, such as combined non‐steroidal anti‐inflammatory drugs, neural nutrition, and traction. Recommendations were either strong or weak, or in the form of ungraded consensus‐based statement.ConclusionThis is the first LDH treatment guideline for TCM and integrative medicine with a systematic search, synthesis of evidence, and using the GRADE method to rate the quality of evidence. We hope these recommendations can help support healthcare workers caring for LDH patients.

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Efficacy of epidural steroid injection in the treatment of sciatica secondary to lumbar disc herniation: a systematic review and meta-analysis

Zhang,

Wang

et al. 2024

Front. Neurol.

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Epidural steroid injection for the treatment of sciatica caused by disc herniation is increasingly used worldwide, but its effectiveness remains controversial. The review aiming to analyze the efficacy of epidural steroid injection on sciatica caused by lumbar disc herniation. Randomized controlled trials (RCTs) investigating the use of epidural steroid injections in the management of sciatica induced by lumbar disc herniation were collected from PubMed and other databases from January, 2008 to December, 2023, with epidural steroid injection in the test group and epidural local anesthetic and/or placebo in the control group. Pain relief rate, assessed by numerical rating scale (NRS) and visual analogue scale (VAS) scores, and function recovery, evaluated by Roland Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI) scores, were recorded and compared. Meta-analysis was performed by Review Manager. In comparison to the control group, epidural steroid injections have been shown to be effective for providing short- (within 3 months) [MD = 0.44, 95%CI (0.20, 0.68), p = 0.0003] and medium-term (within 6 months) [MD = 0.66, 95%CI (0.09,1.22), p = 0.02] pain relief for sciatica caused by lumbar disc herniation, while its long-term pain-relief effect were limited. However, the administration of epidural steroid injections did not lead to a significant improvement on sciatic nerve function in short- [MD = 0.79, 95%CI = (0.39, 1.98), p = 0.19] and long-term [MD = 0.47, 95% CI = (−0.86, 1.80), p = 0.49] assessed by IOD. Furthermore, the analysis revealed that administering epidural steroid injections resulted in a reduction in opioid usage among patients with lumbar disc herniation [MD = −14.45, 95% CI = (−24.61, −4.29), p = 0.005]. The incidence of epidural steroid injection was low. Epidural steroid injection has demonstrated notable efficacy in relieving sciatica caused by lumbar disc herniation in short to medium-term. Therefore, it is recommended as a viable treatment option for individuals suffering from sciatica.

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A Randomized Clinical Study on Acupuncture Therapy for Relieving Sciatica Caused by Lumbar Disc Herniation

Cited by 3 publications

References 18 publications

The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails

The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails

An evidence‐based guideline on treating lumbar disc herniation with traditional Chinese medicine

Efficacy of epidural steroid injection in the treatment of sciatica secondary to lumbar disc herniation: a systematic review and meta-analysis

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