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Review
. 2017 Jul 24:12:21.
doi: 10.1186/s13020-017-0142-0. eCollection 2017.

Cupping therapy versus acupuncture for pain-related conditions: a systematic review of randomized controlled trials and trial sequential analysis

Ya-Jing Zhang #  1 , Hui-Juan Cao #  1 , Xin-Lin Li  1 , Xiao-Ying Yang  1 , Bao-Yong Lai  1 , Guo-Yang Yang  2 , Jian-Ping Liu  1   3
Affiliations
Review

Cupping therapy versus acupuncture for pain-related conditions: a systematic review of randomized controlled trials and trial sequential analysis

Ya-Jing Zhang et al. Chin Med. .

Abstract

Background: Both cupping therapy and acupuncture have been used in China for a long time, and their target indications are pain-related conditions. There is no systematic review comparing the effectiveness of these two therapies.

Objectives: To compare the beneficial effectiveness and safety between cupping therapy and acupuncture for pain-related conditions to provide evidence for clinical practice.

Methods: Protocol of this review was registered in PROSPERO (CRD42016050986). We conducted literature search from six electronic databases until 31st March 2017. We included randomized trials comparing cupping therapy with acupuncture on pain-related conditions. Methodological quality of the included studies was evaluated by risk of bias tool. Mean difference, risk ratio, risk difference and their 95% confidence interval were used to report the estimate effect of the pooled results through meta-analysis or the results from each individual study. Trial sequential analysis (TSA) was applied to adjust random errors and calculate the sample size.

Results: Twenty-three randomized trials with 2845 participants were included covering 12 pain-related conditions. All included studies were of poor methodological quality. Three meta-analyses were conducted, which showed similar clinical beneficial effects of cupping therapy and acupuncture for the rate of symptom improvement in cervical spondylosis (RR 1.13, 95% CI 1.01 to 1.26; n = 646), lateral femoral cutaneous neuritis (RR 1.10, 95% CI 1.00 to 1.22; n = 102) and scapulohumeral periarthritis (RR 1.31, 95% CI 1.15 to 1.51; n = 208). Results from other outcomes (such as visual analogue and numerical rating scale) in each study also showed no statistical significant difference between these two therapies for all included pain-related conditions. The results of TSA for cervical spondylosis demonstrated that the current available data have not reached a powerful conclusion. No serious adverse events related to cupping therapy or acupuncture was found in included studies.

Conclusion: Cupping therapy and acupuncture are potentially safe, and they have similar effectiveness in relieving pain. However, further rigorous studies investigating relevant pain-related conditions are warranted to establish comparative effectiveness analysis between these two therapies. Cost-effectiveness studies should be considered in the future studies to establish evidence for decision-making in clinical practice.

Keywords: Acupuncture; Cupping therapy; Randomized controlled trial; Systematic review; Trial sequential analysis.

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Figures

Fig. 1
Fig. 1
Flow chart of the study
Fig. 2
Fig. 2
Risk of bias summary
Fig. 3
Fig. 3
Forest plot. Cupping therapy versus acupuncture for symptom improvement in patients with cervical spondylosis
Fig. 4
Fig. 4
Trial sequential analysis on cupping therapy versus acupuncture for symptom improvement rate in patients with cervical spondylosis
See this image and copyright information in PMC

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References

    1. Xu XQ, Xu QL, Xie SP, et al. Practice and consideration of non-drug therapy in AIDS prevention and treatment. Chin J Tradit Chin Med Pharm. 2016;31:4912–4915.
    1. Shi XM. Acupuncture and moxibustion therapy. Beijing: People’s Medical Publishing House; 2001. p. 3.
    1. Qaseem A, Wilt TJ, Mclean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017 - PubMed
    1. MacPherson H, Vickers A, Bland M, et al. Acupuncture for chronic pain and depression in primary care: a programme of research. Southampton (UK): NIHR Journals Library; 2017. doi: 10.3310/pgfar05030. - PubMed
    1. Rubinstein SM, van Middelkoop M, Kuijpers T, et al. A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain. Eur Spine J. 2010;19:1213–1228. doi: 10.1007/s00586-010-1356-3. - DOI - PMC - PubMed

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