Article type
Abstract
"Purpose: We enhanced the evidence by incorporating the findings from studies published between September 2016 and February 2024 to the existing evidence from the previous study. Additionally, we conducted a comprehensive review of research that utilized randomized clinical trials (RCTs) to examine the effectiveness of moxibustion as a treatment for patients with osteoarthritis (OA).
Methods: Twelve databases were searched from their inception until February 2024, without imposing any language limits. Two independent reviewers performed data extraction and risk of bias assessments, the included studies were meta-analyzed using RevMan 5.4 software. The quality of the evidence was evaluated using the revised Cochrane risk-of-bias tool and the GRADE (Grading of Recommendations: Assessment, Development and Evaluation) approach.
Results: Fourteen new RCTs were included, a total of 33 RCTs met all inclusion criteria and underwent evaluation. Seventeen RCTs compared the effects of moxibustion with those of conventional oral drug therapies. OA symptom score and the meta-analysis showed superior effects of moxibustion compared with drug therapies for this measure (11 RCTs, n = 969; SMD, −0.52; 95% CI: -1.04 to -0.01; P = 0.05, I2 = 93%), response rate (13 RCTs, n = 1152; RR, 1.11; 95% CI: 1.06 to 1.16, P < 0.0001, I2 = 11%) and pain (11 RCTs, n = 977; SMD, -0.88; 95% CI: -1.37 to -0.39, P = 0.06, I2 = 91%). 11 RCTs found superior effects of moxibustion on response rate (9 RCTs, n = 580; RR, 1.11; 95% CI: 1.02 to 1.21, P =0.02, I2 = 50%) and pain (5 RCTs, n = 362; SMD, -2.10; 95% CI: -3.56 to -0.63, P = 0.05, I2 = 97%) compared with intra-articular injection or topical drug therapy.
Conclusion: This updated systematic review and meta-analysis suggests that moxibustion is effective in reducing pain and managing symptoms in KOA, when compared to oral drugs, intra-articular injection, or topical drug therapy. However, due to the limited level of evidence in this SR, further high-quality RCTs are still needed to confirm these findings.
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Methods: Twelve databases were searched from their inception until February 2024, without imposing any language limits. Two independent reviewers performed data extraction and risk of bias assessments, the included studies were meta-analyzed using RevMan 5.4 software. The quality of the evidence was evaluated using the revised Cochrane risk-of-bias tool and the GRADE (Grading of Recommendations: Assessment, Development and Evaluation) approach.
Results: Fourteen new RCTs were included, a total of 33 RCTs met all inclusion criteria and underwent evaluation. Seventeen RCTs compared the effects of moxibustion with those of conventional oral drug therapies. OA symptom score and the meta-analysis showed superior effects of moxibustion compared with drug therapies for this measure (11 RCTs, n = 969; SMD, −0.52; 95% CI: -1.04 to -0.01; P = 0.05, I2 = 93%), response rate (13 RCTs, n = 1152; RR, 1.11; 95% CI: 1.06 to 1.16, P < 0.0001, I2 = 11%) and pain (11 RCTs, n = 977; SMD, -0.88; 95% CI: -1.37 to -0.39, P = 0.06, I2 = 91%). 11 RCTs found superior effects of moxibustion on response rate (9 RCTs, n = 580; RR, 1.11; 95% CI: 1.02 to 1.21, P =0.02, I2 = 50%) and pain (5 RCTs, n = 362; SMD, -2.10; 95% CI: -3.56 to -0.63, P = 0.05, I2 = 97%) compared with intra-articular injection or topical drug therapy.
Conclusion: This updated systematic review and meta-analysis suggests that moxibustion is effective in reducing pain and managing symptoms in KOA, when compared to oral drugs, intra-articular injection, or topical drug therapy. However, due to the limited level of evidence in this SR, further high-quality RCTs are still needed to confirm these findings.
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