Objective: This study aims to evaluate the effectiveness and safety of electroacupuncture for nonspecific chronic low back pain.
Methods: 9 databases (MEDLINE, CENTRAL, EMBASE, Koreamed, KMBASE, KISS, NDSL, KISTI, OASIS) were searched from inception to September 2016. Randomized controlled studi...
Objective: This study aims to evaluate the effectiveness and safety of electroacupuncture for nonspecific chronic low back pain.
Methods: 9 databases (MEDLINE, CENTRAL, EMBASE, Koreamed, KMBASE, KISS, NDSL, KISTI, OASIS) were searched from inception to September 2016. Randomized controlled studies using electroacupuncture treatment for nonspecific chronic low back pain were selected. There were no restrictions according to publication status. Data from the selected studies were extracted using a formal extraction tool. The risk of bias of each of the selected studies was assessed using the Cochrane risk of bias tool. For continuous data, mean difference or standardized mean difference. Heterogeneity between the selected studies was assessed using the forest plot and Chi-square test. Assessment of levels of evidence was conducted.
Results: 3,282 records were verified from the searched databases. After screening the records, 5 studies involving 286 participants were included in this systematic review. Electroacupuncture as an alternative treatment showed a significant effect on pain relief compared with other treatments including medication, exercise, and no treatment (SMD -0.67, 95% CI: -1.34 to 0.00; χ2=10.58, p=.01, I2=72%), but did not show a significant effect compared with electrical heat acupuncture(EH) (SMD 0.38, 95% CI -0.37 to 1.13). Electroacupuncture as an add-on treatment showed a significant effect on pain relief compared with other treatments including medication, and exercise (SMD -0.85, 95% CI: -1.40 to -0.31, χ2=1.54, p=.21, I2=35%). Electroacupuncture as an add-on treatment showed a significant effect on pain relief variation compared with standard therapy (MD -0.60, 95% CI -1.26 to 0.06). Electroacupuncture as an alternative treatment showed a significant effect on controls on disability compared with other treatments including medication, exercise, and no treatment (MD -1.90, 95% CI: -3.55 to -0.24; χ2=11.56, p=.009, I2=74%), but did not show a significant effect compared with EH (MD 0.21, 95% CI -1.14 to 1.56). EA did not show a significant effect on improving ROM compared with exercise. EA as an add-on treatment showed significant effect on global transition scale and change of medication dose compared with standard therapy. There was 1 study reported adverse events related with electroacupuncture. The level of evidence was assessed from low to moderate.
Conclusion: This systematic review suggests that electroacupuncture as an alternative and add-on treatment has a significant effect on reducing pain and improve the function. However, further studies with a high methodological quality are needed to establish a conclusive evidence about the effectiveness and safety of electroacupuncture for nonspecific chronic low back pain. And further studies about safety of electroacupuncture should be conducted.
Objective: This study aims to evaluate the effectiveness and safety of electroacupuncture for nonspecific chronic low back pain.
Methods: 9 databases (MEDLINE, CENTRAL, EMBASE, Koreamed, KMBASE, KISS, NDSL, KISTI, OASIS) were searched from inception to September 2016. Randomized controlled studies using electroacupuncture treatment for nonspecific chronic low back pain were selected. There were no restrictions according to publication status. Data from the selected studies were extracted using a formal extraction tool. The risk of bias of each of the selected studies was assessed using the Cochrane risk of bias tool. For continuous data, mean difference or standardized mean difference. Heterogeneity between the selected studies was assessed using the forest plot and Chi-square test. Assessment of levels of evidence was conducted.
Results: 3,282 records were verified from the searched databases. After screening the records, 5 studies involving 286 participants were included in this systematic review. Electroacupuncture as an alternative treatment showed a significant effect on pain relief compared with other treatments including medication, exercise, and no treatment (SMD -0.67, 95% CI: -1.34 to 0.00; χ2=10.58, p=.01, I2=72%), but did not show a significant effect compared with electrical heat acupuncture(EH) (SMD 0.38, 95% CI -0.37 to 1.13). Electroacupuncture as an add-on treatment showed a significant effect on pain relief compared with other treatments including medication, and exercise (SMD -0.85, 95% CI: -1.40 to -0.31, χ2=1.54, p=.21, I2=35%). Electroacupuncture as an add-on treatment showed a significant effect on pain relief variation compared with standard therapy (MD -0.60, 95% CI -1.26 to 0.06). Electroacupuncture as an alternative treatment showed a significant effect on controls on disability compared with other treatments including medication, exercise, and no treatment (MD -1.90, 95% CI: -3.55 to -0.24; χ2=11.56, p=.009, I2=74%), but did not show a significant effect compared with EH (MD 0.21, 95% CI -1.14 to 1.56). EA did not show a significant effect on improving ROM compared with exercise. EA as an add-on treatment showed significant effect on global transition scale and change of medication dose compared with standard therapy. There was 1 study reported adverse events related with electroacupuncture. The level of evidence was assessed from low to moderate.
Conclusion: This systematic review suggests that electroacupuncture as an alternative and add-on treatment has a significant effect on reducing pain and improve the function. However, further studies with a high methodological quality are needed to establish a conclusive evidence about the effectiveness and safety of electroacupuncture for nonspecific chronic low back pain. And further studies about safety of electroacupuncture should be conducted.
Keyword
#전침, 비특이적 만성 요통, 통증, 기능부전, 체계적 문헌고찰
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