A Meta-analysis of the Efficacy of Acupuncture Therapy Combined with Percutaneous Vertebroplasty in the Treatment of Osteoporotic Fractures

Abstract

Objective: To explore the safety and effectiveness of acupuncture combined with percutaneous vertebroplasty in the treatment of osteoporotic fractures by Meta-analysis. Methods: The domestic and foreign medical databases including VIP, Chinese Clinical trial Registry, CNKI, Wanfang, CBM and foreign databases including PubMed, Embase, Cochrane Library, Cilnical trial were searched by computer. The retrieval content was randomized controlled trials of acupuncture and moxibustion combined with percutaneous vertebroplasty in the treatment of osteoporotic fractures. The selected outcome indicators were total effective rate, incidence of adverse reactions, VAS score, dysfunction index and cobb Angle. For the type of statistical index, the total effective rate and the incidence of adverse reactions were dichotomous variables, and VAS score, dysfunction index, and cobb Angle index were continuous variables. Two researchers independently included and excluded the literature. Strict quality evaluation was used to evaluate the quality of the literature that met the criteria, and the data were strictly extracted. The tools for assessing the risk of bias in the Cochrane Handbook for Systematic Reviews and the jadad quality assessment scale were used. After data extraction, Revman5.4 software was used for Meta-analysis. Results: A total of 2587 articles were included. The treatment methods included acupuncture + surgery, traditional Chinese medicine + surgery, simple surgery, etc. The Jadad score showed that the quality of the included literature was average. The Cochrane review showed that the risk of bias of the included studies was moderately high. Meta-analysis results showed that: Acupuncture and moxibustion combined with vertebroplasty had better clinical efficacy than vertebroplasty alone in the treatment of osteoporotic compression fractures, which could significantly improve the total effective rate [OR=5.55, 95% CI (2.22, 13.88), P=0.0002], VAS score [MD=-0.90, P=0.000], and the difference was statistically significant (P < 0.05). 95% CI (1.14, 0.66), P < 0.00001], ODI score [MD = 4.88, 95% CI (7.03, 2.74), P < 0.00001], cobb Angle [MD = 6.77, 95% CI (7.14, 6.41), P < 0.00001] were statistically significant (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups before and after treatment [OR=0.39, 95% CI (0.07, 2.05), P=0.27] (P > 0.05), which suggested that the two treatment schemes were similar in safety and were reliable treatment methods. Conclusion: Compared with the simple operation, acupuncture therapy combined with operation in the treatment of osteoporotic fracture has better effect, can reduce VAS score, improve ODI index, improve the quality of life of patients, correct cobb Angle, and has better safety, can improve postoperative pain and movement disorders and other complications, has good application value.