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The effectiveness and safety of acupuncture in the treatment of lumbar disc herniation: Protocol for a systematic review and meta-analysis.

ABSTRACT: BACKGROUND:Lumbar disc herniation (LDH) is a common disease that seriously affects patients' quality of life. Although several articles have reported that acupuncture can improve the symptoms of LDH, different guidelines do not evaluate the efficacy of acupuncture consistently, new randomized controlled trials have been published in recent years.The purpose of this study is to evaluate the efficacy and safety of acupuncture for LDH. METHOD:Electronic resource databases, trial registration platform, and different types of grey literature will be systematically searched for eligible studies by 2 authors independently. The type of trial will be limited to randomized controlled trials on acupuncture treatment for LDH. Search strategy will be a combination of terms associated with LDH (eg, low back pain or sciatica) and study of design (eg, randomized controlled trials or clinical trial). Data from homogeneous studies will be combined in a fixed-effects model, and the evidence level will be measured by grading of recommendations assessment, development, and evaluation. RESULTS:This study will provide high-quality evidence to evaluate the relief of pain intensity and improvement of dysfunction of acupuncture in patients with LDH, and to evaluate the safety of acupuncture. CONCLUSION:This study will provide strong evidence for evaluating whether acupuncture therapy is effective and safe for LDH patients. PROSPERO REGISTRATION NUMBER:CRD 42019137399.

SUBMITTER: Deng R

PROVIDER: S-EPMC7220427 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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The effectiveness and safety of acupuncture in the treatment of lumbar disc herniation: Protocol for a systematic review and meta-analysis.

Deng Rong R Huang ZiLing Z Li Xun X Pei XingHong X Li ChengXi C Zhao JianXin J

Medicine 20200301 12

<h4>Background</h4>Lumbar disc herniation (LDH) is a common disease that seriously affects patients' quality of life. Although several articles have reported that acupuncture can improve the symptoms of LDH, different guidelines do not evaluate the efficacy of acupuncture consistently, new randomized controlled trials have been published in recent years.The purpose of this study is to evaluate the efficacy and safety of acupuncture for LDH.<h4>Method</h4>Electronic resource databases, trial regi ...[more]

PMID: 32195925

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Project description:ObjectiveLumbar disc herniation (LDH) is based on the degenerative changes of the intervertebral disc. Many drugs are used to treat and prevent LDH, including Western medicine and Chinese medicine. Duhuo Jisheng Decoction (DHJSD) is one of the most classic Chinese medicine prescriptions. The purpose of our meta-analysis is to evaluate the efficacy and safety of modified DHJSD in the treatment of LDH.MethodsWe searched multiple databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI) databases, Wanfang Database, and Chinese Scientific Journal Database (VIP) to identify studies that met the inclusion criteria. This meta-analysis was registered at INPLASY with reference number ID: INPLASY202060053.ResultsFourteen randomized controlled trials (RCTs) were identified, including 1560 patients. This meta-analysis showed that the total effective rate and cure rate of modified DHJSD are higher than those of diclofenac sodium enteric-coated tablets (total effective rate: RR = 1.18, 95% CI: 1.12 to 1.25, P < 0.0001, I 2 = 0%; cure rate: RR = 1.60, 95% CI: 1.30 to 1.97, P < 0.00001, I 2 = 2%), diclofenac sodium enteric-coated tablets plus ibuprofen and indomethacin (total effective rate: RR = 1.23, 95% CI: 1.11 to 1.37, P=0.0001, I 2 = 0%; cure rate: RR = 1.58, 95% CI: 1.22 to 2.04, P=0.0005, I 2 = 0%), and diclofenac sodium sustained-release capsule (total effective rate: RR = 1.49, 95% CI: 1.27 to 1.74, P < 0.00001, I 2 = 0%; cure rate: RR = 10.07, 95% CI: 3.29 to 30.88, P < 0.00001, I 2 = 5%). Modified DHJSD was also better than Western medicine (MD = -1.56, 95% CI: -2.42 to -0.70, P=0.0004, I 2 = 74%) in terms of visual analogue scale (VAS) scores. Three RCTs showed no adverse events in the modified DHJSD group, but adverse events existed in the Western medicine group.ConclusionThis meta-analysis showed that modified DHJSD had a more favorable effect on the treatment of LDH than Western medicine, and there were no obvious adverse events. More high-quality RCTs are needed to complement existing conclusions.

Dataset Information

The effectiveness and safety of acupuncture in the treatment of lumbar disc herniation: Protocol for a systematic review and meta-analysis.

Publications

The effectiveness and safety of acupuncture in the treatment of lumbar disc herniation: Protocol for a systematic review and meta-analysis.

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