Clinical Efficacy of Tuina Therapy for Acute Lumbar Sprain: A Bayesian Network Meta-Analysis Based on Randomized Controlled Trials

推拿疗法治疗急性腰椎扭伤的临床疗效:基于随机对照试验的贝叶斯网络荟萃分析

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Abstract

PURPOSE: Traditional Chinese medicine possesses distinct advantages in the treatment of acute lumbar sprains, and Tuina (Chinese massage) is a commonly employed therapeutic method. This study employed a Bayesian meta-analysis to assess the efficacy and safety of Tuina therapy for acute lumbar sprain with the aim of providing more evidence-based medical substantiation for clinical practice. PATIENTS AND METHODS: Randomized controlled trials of Tuina therapy for acute lumbar sprains published in CNKI, CSPD, CCD, CBM, PubMed, Embase, Cochrane Library, and Web of Science were searched up to August 7, 2024. The included studies were assessed for the risk of bias using Cochrane's randomized controlled trial bias risk assessment tool. RESULTS: Eleven studies involving 810 patients were included in this meta-analysis. Two types of interventions were included: Tuina alone and Tuina combined with conventional treatment. The included studies had a low risk of bias. Three outcome indicators were analyzed. The results of the network meta-analysis showed that, compared with conventional treatment, Tuina alone or in combination with other interventions had a significant advantage in terms of efficacy (P < 0.05). The order of the surface under the cumulative ranking curve (SUCRA) was: Tuina (0.79) and Tuina combined with conventional treatment (0.70). Regarding the visual analog scale score, Tuina combined with the other interventions showed significant advantages (P < 0.05). The order of SUCRA was: Tuina combined with conventional treatment (0.80), followed by Tuina alone (0.64). Regarding the modified Japanese Orthopaedic Association scores, Tuina combined with conventional treatment had a significant advantage (P < 0.05). The order of SUCRA was Tuina combined with conventional treatment (0.98), followed by Tuina alone (0.26). CONCLUSION: The results suggest that Tuina has significant advantages over conventional treatment.

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