The Efficacy and Safety of Simple‐Needling Therapy for Treating Ankylosing Spondylitis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Abstract

Background. Clinical investigators have found that the use of needling in the treatment of ankylosing spondylitis (AS) has a good clinical application prospect in recent years. However, these studies were insufficient to provide evidence for the efficacy and safety of simple-needling for AS. So, we performed a systematic review and meta-analysis to evaluate the efficacy and safety of simple-needling for treating AS. Methods. We searched the PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wangfang database (Wanfang), Chinese Science and Technology Periodical Database (VIP), and any other gray literature sources for randomized controlled trials (RCTs) that used simple-needling to treat AS before June 2019 with the language restriction of Chinese and English. Researchers evaluated the retrieved literature studies and extracted valid data according to relevant requirements and used RevMan5.3 software for meta-analysis. Results. A total of 10 studies were included, all of which were Chinese literature studies, involving 729 patients. Compared with the control groups, simple-needling groups had a better effect on the clinical effective rate (RR = 1.20, 95% CI (1.11, 1.29), P<0.00001), TCM syndrome score (MD = −5.26, 95% CI (−5.99, −4.53), P<0.00001), symptom score (MD = −8.08, 95% CI (−10.18, −5.97), P<0.00001), and Schober test outcome (MD = 0.39, 95% CI (0.15, 0.64), P=0.002). Sensibility analysis was based on the leave-one-out cross-validation procedure, and the results showed no significant changes. Most studies did not describe adverse reactions. The funnel plot suggested publication bias on clinical effectiveness. Conclusions. This systematic review and meta-analysis demonstrated that simple-needling was effective as an intervention for AS. However, due to the low quality of the methodology of included studies, the designs of clinical trials were not rigorously standardized. Therefore, it is necessary to carry out multiquality RCTs for verification.

Assessment of complementary and alternative medicine methods in the management of ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome

“…In warm acupuncture, acupuncture and moxibustion are used together [71]. The meta-analysis by Xuan et al [72] aimed to evaluate the effectiveness of needling alone in AS patients. Although beneficial results were reported in this meta-analysis, which included randomized controlled trials, emphasis was placed on methodological shortcomings and low quality of evidence.…”

Comparison of Efficacy of Acupuncture-Related Therapy in the Treatment of Rheumatoid Arthritis: A Network Meta-Analysis of Randomized Controlled Trials

“…Acupuncture is a complementary and alternative therapy based on the meridian theory in traditional Chinese medicine (TCM). It has been widely used in the treatment of knee osteoarthritis ( 10 ), ankylosing spondylitis ( 11 , 12 ), and other arthritis, with a good effect. Acupuncture could improve patient’s symptoms, delay the progression, and reduce pain in the treatment of RA ( 13 , 14 ).…”

TCM nonpharmacological interventions for ankylosing spondylitis

“…Traditional Chinese medicine (TCM), as a main component of CAM based on current knowledge, has been widely applied in the management of chronic conditions including AS in the world. [ 15 , 16 ]…”