推拿治疗非特异性腰痛临床疗效评价:一项基于随机对照试验的贝叶斯网状Meta分析OA

Objective:To assess the efficacy and safety of Tuina(Chinese therapeutic massage)for non-specific low back pain(NLBP)by employing a Bayesian network meta-analysis,with the aim of providing robust evidence-based insights for clinical applications. Methods:A comprehensive search was conducted for randomized controlled trials(RCTs)evaluating Tuina for NLBP across multiple databases,including China National Knowledge Infrastructure,China Science Periodical Database,Chinese Science Citation Database,Chinese Biomedical Literature Database,PubMed,Embase,Cochrane Library,and Web of Science,from each database's inception to February 13,2025.The included studies were assessed for the risk of bias using the Cochrane risk-of-bias assessment tool tailored for RCTs.A network meta-analysis was conducted using Stata 19 and R version 4.2.0.The mean difference(MD)and confidence interval(CI)were used for statistical descriptions. Results:No statistically significant differences were noted in the efficacy among various interventions.However,the surface under the cumulative ranking curve(SUCRA)indicated that the combination of Tuina and acupuncture yielded the most favorable outcomes.Regarding the visual analog scale,Tuina combined with routine exercise training exhibited notable benefits compared with Tuina[MD=-1.41;95%CI(-1.92,-0.82)].SUCRA analysis further confirmed that Tuina combined with routine exercise training achieved optimal outcomes regarding both the visual analog scale score and the Oswestry disability index,but no significant differences were observed among interventions. Conclusion:The findings suggest that combining Tuina with either routine exercise training or acupuncture offers superior benefits over standard treatments for managing NLBP.However,due to the limited number of studies included in this analysis,further high-quality RCTs are warranted to substantiate these findings regarding efficacy and safety.