Acupuncture versus Lornoxicam in the Treatment of Acute Renal Colic: A Randomized Controlled Trial

Zhang, Xiaohua; Liu, Xinguo; Ye, Qiongxiang; Wang, Xunbao; Chen, Jinjun; Wang, Zhiyong; Zhao, Pengfei; Tao, Baozhou; Xu, Guoping; Xu, Wanfeng; Wu, Kan; Xiao, Yao; Li, Yang; Tian, Junqiang; Wang, Juan; Dong, Zhilong; Wang, Zhiping

doi:10.2147/jpr.s339006

Cited by 2 publications

(20 citation statements)

References 41 publications

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“…After removing the repetition, there are 477 articles left, 18 articles are left after reading titles and abstracts, and 15 articles are selected after reading the full text (Figure 1). [12,13,[18][19][20][21][22][23][24][25][26][27][28][29][30] were included in this study, including 1210 subjects aged from 18 to 81-579 patients in the experimental group and 631 patients in the control group (Tables 1 and 2). ere are 11 Chinese literatures and 4 English literatures.…”

Section: Search and Screeningmentioning

confidence: 99%

“…ere are 11 Chinese literatures and 4 English literatures. 13 studies [18][19][20][21][22][23][24][25][26][27][28][29][30] were carried out in China, 1 study [13] in Tunisia, and 1 study [12] in Turkey. 14 studies were published and 1 study [30] was unpublished.…”

Section: Search and Screeningmentioning

confidence: 99%

“…Random is mentioned in all studies. 6 studies [13,18,23,24,26,30] explain the random method, which is the random number table method, the rest of the studies did not describe enough information. With the exception of 3 studies [13,18,30], rest of the 12 studies [12,[19][20][21][22][23][24][25][26][27][28][29] did not have enough description to support clear judgments on allocation concealment.…”

Section: Risk Of Bias In Includedmentioning

confidence: 99%

“…e blinding of outcome assessors was described in only 2 studies [18,30] at low risk of bias; the risk of bias in others was unclear, as there was no explanation we could assess the risk of bias. With the exception of 3 studies [13,18,26], rest of the 12 studies [12,[19][20][21][22][23][24][25][27][28][29][30] were rated low risk for complete outcome data.…”

Section: Risk Of Bias In Includedmentioning

confidence: 99%

“…A total of 13 studies [13,[18][19][20][21][22][23][24][25][27][28][29][30] reported effective rates, of which 8 studies used manual acupuncture as a monotherapy in the experimental group and 5 used acupuncture as an adjuvant therapy in the experimental group. Meta-analysis shows that compared to the control group, 8 studies [13,[18][19][20][21][22][23][24] which were manual acupuncture as a monotherapy is more likely to lead to improvements in response rate (RR � 1.10(95% CI: 1.03, 1.18), I 2 � 28%, P � 0.004) with a high degree of homogeneity. Compared with the control group, acupuncture as an adjuvant therapy included 5 studies [25,[27][28][29][30], there was no statistical difference (RR � 1.06 (95% CI: 0.95, 1.20), I 2 � 77%, P � 0.30) (Figure 5).…”

Section: Response Ratementioning

confidence: 99%

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Efficacy and Safety of Acupuncture in Renal Colic Caused by Urinary Calculi in Adults: A Systematic Review and Meta-Analysis

Wang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. Acute renal colic caused by urinary calculi has a considerable impact on the quality of life. Pain relief is the primary goal in the management of patients with acute renal colic caused by urinary calculi. At present, there is no systematic evaluation of the efficacy and safety of manual acupuncture in the treatment of acute renal colic caused by urinary calculi in adults. Objective. To evaluate the efficacy and safety of manual acupuncture in the treatment of acute renal colic caused by urinary calculi in adults. Methods. Databases of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Medical, VIP Database for Chinese Technical Periodicals (VIP), and China Biomedical Literature (SinoMed) were searched for literature and other randomized controlled registration platforms. We searched to identify the relevant randomized controlled trials from the establishment of the database to February 9, 2022. Only randomized controlled trials (RCTs) of manual acupuncture as the therapy for acute renal colic caused by urinary calculi in adults were included, whether or not the blind method is used. The patients were adults diagnosed with urinary calculi and renal colic. The control group was treated with commonly used analgesics and antispasmodics. The experimental group was treated with acupuncture as a monotherapy or as an adjuvant therapy (manual acupuncture combined with analgesics and antispasmodics). Two review authors independently assessed titles and abstracts for relevance and extracted data on study design, participants, interventions, and outcomes from potentially relevant articles. Cochrane risk bias assessment tool was used to evaluate the quality of the included study, and RevMan5.4 software was used for meta-analysis. Our primary outcomes were response rate and time duration before pain remission. Secondary outcomes were the time of complete pain relief, pain variation, need for rescue analgesia, and adverse events. Results. Out of 1123 records identified, 15 were found to be of relevance to this study, and 1210 participants were included in the meta-analysis. The meta-analysis of the results shows that, in terms of response rate, compared with the control group, acupuncture as a monotherapy seems to have a slight advantage (RR = 1.10 (95% CI: 1.03, 1.18), I2 = 28%, P = 0.004 ), while acupuncture as an adjuvant therapy has no advantage (RR = 1.06 (95% CI: 0.95, 1.20), I2 = 77%, P = 0.30 ). In terms of duration before pain relief, acupuncture as a monotherapy had an advantage over the control group (MD = −10.28(95% CI: −14.40, −6.17), I2 = 93%, P < 0.00001 ). Acupuncture as a monotherapy was similar to positive medication in terms of complete pain relief (MD = −7.13 (95% CI: −20.19, 5.94), I2 = 95%, P = 0.28 ). Pain variation: VAS scores at 10 min, acupuncture as a monotherapy (MD = −2.47 (95% CI: −3.40, −1.53), I2 = 84%, P < 0.00001 ) or as an adjuvant therapy (MD = −3.38 (95% CI: −4.33, −2.43), I2 = 60%, P < 0.00001 ) was better than the control group. VAS scores at 30 min, compared with the control group, there was no difference between acupuncture as a monotherapy (MD = −0.27 (95% CI: −1.43, 0.88), I2 = 88%, P = 0.64 ) and acupuncture as an adjuvant therapy (MD = −1.17 (95% CI: −3.15, 0.81), I2 = 96%, P = 0.25 ). VAS scores at 60 min, compared with the control group, there was no difference in the acupuncture as a monotherapy (MD = 0.58 (95% CI: −0.28, 1.45), I2 = 77%, P = 0.19 ), while acupuncture as an adjuvant therapy was better (MD = −1.22 (95% CI: −1.93, −0.51), I2 = 72%, P = 0.0007 ). VAS scores at 120 min, there was no difference in acupuncture as a monotherapy compared to the control group (MD = −0.24 (95% CI:−1.22, 0.75), I2 = 0, P = 0.64 ). One study reported on rescue analgesia. Fewer adverse events occurred in the experimental group compared to the control group. Conclusion. In the course of manual acupuncture treatment of acute renal colic caused by urinary calculi in adults, available evidence suggests that manual acupuncture is as effective as positive treatment drugs, either as a monotherapy or as an adjunctive therapy, with the advantage of acupuncture being its rapid onset of action. However, the number of existing clinical studies is small, and the quality of evidence is generally low, so it is recommended to use it with caution. In order to further verify the above conclusions, more high-quality clinical RCTs need to be carried out. Trial Registration. The present review protocol was registered with the International Prospective Register of Systematic Reviews (CRD42019134900).

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Section: Search and Screeningmentioning

confidence: 99%

Section: Search and Screeningmentioning

confidence: 99%

Section: Risk Of Bias In Includedmentioning

confidence: 99%

Section: Risk Of Bias In Includedmentioning

confidence: 99%

Section: Response Ratementioning

confidence: 99%

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Efficacy and Safety of Acupuncture in Renal Colic Caused by Urinary Calculi in Adults: A Systematic Review and Meta-Analysis

Wang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Clinical efficacy of acupuncture for pain relief from renal colic: A meta-analysis and trial sequence analysis

et al. 2023

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BackgroundThis meta-analysis aimed at investigating the efficacy of acupuncture for relieving renal colic and reducing the risk of analgesic-related complications.MethodsRandomized controlled trials (RCTs) comparing the efficacy of acupuncture (acupuncture group) with conventional interventions (control group) were screened from MEDLINE, EMBASE, Cochrane library databases, China Knowledge Network (CNKI), and Airiti Library till July 15, 2022. The primary outcome was the rate of effective pain relief (response rate), while secondary outcomes included the time of onset of pain relief, visual analog scale (VAS) at 30–60 min and risk of side effects.ResultsThirteen eligible studies involving 1,212 participants published between 1992 and 2021 were analyzed. Compared with the control group, patients receiving acupuncture had a higher overall response rate [risk ratio (RR) = 1.12, 95% CI: 1.05–1.19, p = 0.0002, I2 = 41%, 1,136 patients] (primary outcome) and a faster pain relief [MD = −10.74 min, 95% CI: −12.65 to −8.82, p < 0.00001, I2 = 87%, 839 patients]. Patients receiving acupuncture had a lower pain score [MD = −0.65, 95% CI: −1.09 to −0.21, p = 0.21, I2 = 55%, 327 patients] and risk of side effects (RR = 0.11, 95% CI: 0.04–0.26, p < 0.00001, I2 = 0, 314 patients) compared to those receiving conventional interventions. Results from trial sequence analysis revealed sufficient evidence supporting the beneficial effects of acupuncture on response rate, time to pain relief, and pain score at 30–60 min.ConclusionCompared with conventional analgesic-based interventions, acupuncture can more efficiently relieve renal colic with fewer adverse effects. The limited number and quality of included studies warrant more clinical RCTs to support our findings.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022346714.

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Acupuncture versus Lornoxicam in the Treatment of Acute Renal Colic: A Randomized Controlled Trial

Cited by 2 publications

References 41 publications

Efficacy and Safety of Acupuncture in Renal Colic Caused by Urinary Calculi in Adults: A Systematic Review and Meta-Analysis

Efficacy and Safety of Acupuncture in Renal Colic Caused by Urinary Calculi in Adults: A Systematic Review and Meta-Analysis

Clinical efficacy of acupuncture for pain relief from renal colic: A meta-analysis and trial sequence analysis

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