Background
Methods
Inclusion criteria
Identification and selection of studies
Data extraction and risk of bias assessment
Data analysis
Trial sequential analysis (TSA)
Results
Basic information of included studies
Description of interventions
Study ID | Diseases | Sample size | Age | Gender | Cupping group | Acupuncture group | Treatment duration (days) | Outcomes |
---|---|---|---|---|---|---|---|---|
(Rx/C) | Year (Rx/C) | M/F | ||||||
Dong [18] | Cervical spondylosis of vertebral artery type | 60/60 | 40.62 ± 14.57 41.15 ± 13.34 | 33/27 34/26 | Wet cupping on Haoyi acupoint. If not effect, wet cupping on Zhengumai acupoint after 3 days and evaluate the effect on the seventh day | Acupuncture on bilateral cervical (C3–7), Jiaji (EX-B2) points, Dazhui (DU14), Fengchi (GB20), Neiguan (PC6), Hegu (LI4) with stimulation. 1×/day | 15 | Symptom score, total effective rate |
Zhou [19] | Cervical spondylosis | 100/100 | 20–60 | Not reported | With Zhuang medicine lotus needle pricking and cupping therapy. 1×/2 days | Acupuncture on bilateral cervical (C3–7), Jiaji (EX-B2) points, Dazhui (DU14), Fengchi (GB20), Neiguan (PC6), Hegu (LI4) with stimulation. 1×/day | 20 | VAS, symptom improvement rate |
Hu [20] | Cervical spondylosis of vertebral artery type | 20/20 | 40.9 ± 3.5 42.8 ± 1.6 | 12/8 10/10 | Wet cupping on Haoyi acupoint. If not effect, wet cupping on Zhengumai acupoint after 3 days and evaluate the effect on the seventh day | Acupuncture on bilateral cervical (C3–7), Jiaji (EX-B2) points, Dazhui (DU14), Fengchi (GB20), Neiguan (PC6), Hegu (LI4) with stimulation 30 min. 1×/day | 15 | Symptom improvement rate |
Mou [21] | Cervical spondylotic radiculopathy | 68/56 | 46.4 ± 11.6 47.8 ± 11.9 | 34/34 24/32 | Wet cupping on Dazhui (GV14) and Jianjing (GB21) acupoint 2×/week | Acupuncture on bilateral cervical (C3–7), Jiaji (EX-B2) points and Jianjing (GB 21) on the affected side, 30 min, 2×/week | 60 | VAS, NDI, CAS |
A [22] | Cervical spondylosis | 43/43 | 45.3 ± 9.4 44.2 ± 9.2 | 23/20 22/21 | Wet cupping on Haoyi acupoint. If not effect, wet cupping on Zhengumai acupoint after 9 days | Acupuncture on bilateral cervical (C3–7), Jiaji (EX-B2) points, Dazhui (DU14), Fengchi (GB20), Neiguan (PC6), Hegu (LI4) with stimulation, 1×/day, 25 min | 14 | Symptom improvement rate |
Wang [23] | Cervical spondylosis | 72/72 | 45.9 ± 8.7 45.1 ± 7.9 | 79/65 | Wet cupping on Haoyi acupoint for 10 min. If not effect, wet cupping on Zhengumai acupoint after 3 days | Acupuncture on Fengchi (GB20), Wangu (GB12), Sishencong (EX-HN1), Baihui (GV20), Tianzhu (BL10), Yunting, Jiaji (EX-B2), 1×/day, 25 min | 14 | Symptom improvement rate |
Na [24] | Cervical spondylosis | 28/28 | 45.1 ± 8.5 44.3 ± 8.9 | 15/13 17/11 | Wet cupping on Haoyi acupoint. If not effect, wet cupping on Zhengumai acupoint after 9 days and evaluate the effect on the 12 day | Acupuncture on bilateral cervical (C3–7), Jiaji (EX-B2) points, Dazhui (DU14), Fengchi (GB20), Neiguan (PC6), Hegu (LI4) with stimulation, 1×/day, 25 min | 14 | Symptom improvement rate |
Wang [25] | Knee osteoarthritis | 40/40 | 42–68 | 62/58 | Wet cupping on tender point (Ashi), Xiyan (EX-LE5), Heding (EX-LE2), Yanglingwquan (GB34), Liangqiu (ST34), 1×/2 days | Acupuncture: abdominal acupuncture on Zhongwan (N12), Guanyuan (N4), Shuifen (RN9), Qipang, Waling, Xiafengshidian, Xiafenshineidian with stimulation, 30 min | 23 | Symptom improvement rate |
Wang [26] | Knee osteoarthritis | 89/82 | 59 ± 9 61 ± 8 | 18/71 21/61 | Wet cupping on Xiyan (EX-LE2), tender acupoints (Ashi) for 5–10 times | Acupuncture on Xiyan (EX-LE2), tender acupoints (Ashi), 20 min for 5–10 times | 28 | VAS, WOMAC |
Shu [27] | Lateral femoral cutaneous neuritis | 25/25 | 50.32 ± 10.44 50.88 ± 9.27 | 14/11 12/13 | Wet cupping on tender point and Yanglingquan (GB34), 30 min, 1×/2 days | Local multiple superficial needling, 30 min, 1×/2 days | 21 | Symptom improvement rate |
Zhang [28] | Lateral femoral cutaneous neuritis | 26/26 | 46.9 47.6 | 20/6 21/5 | Wet cupping on tender point | Local Multiple superficial needling, 30 min, 1×/2 days | 21 | Symptom improvement rate |
Wang [29] | Lumber disk herniation | 32/30 | 20–60 | 48/45 | Wet cupping in tender point (Ashi) and surface reflect lesion site and retained for 5–1 min, 1×/2 days | Acupuncture on traditional site, 30 min, 1×/day. | 28 | JOA score, symptom improvement rate |
Zhou [30] | The third lumber vertebral transverse process syndrome | 60/60 | 35.1 35.9 | 38/22 34/26 | Wet cupping on tender point (Ashi) and retained cupping for 5 min | Acupuncture on Ashi, Jiaji (EX-B2), Huantiao (GB30), Weizhong (BL40), 20 min, 1×/2 days | 28 | VAS, Symptom improvement rate |
Zhang [31] | Postherpetic neuralgia | 20/20 | 61 ± 7 60 ± 7 | 12/8 13/7 | Wet cupping on Ashi for 3–10 min, 1×/2 days | Acuponcture around the pain site for 20–30 mins, 1×/day | 10 | Symptom improvement rate |
Huang [32] | Postherpetic neuralgia | 49/47 | 65.35 64.28 | 28/21 25/22 | Wet cupping with Zhuang lotus needle on Longji, Jiaji (EX-B2), Jianjing (GB21), Ashi and retained cupping for 5–10 min, 1×/2 days | Acupuncture on Quchi (LI11), Hegu (LI4), Taichong (LR3), Sanyinjiao (SP6), Xuehai (SP10), Zusanli (ST36) and tender points (Ashi), 25 min. 1×/day | 30 | Symptom improvement rate, VAS |
Wu [33] | Toothache | 204/203 | Not reported | Not reported | Wet cupping on Dazhui (DU14), Jiaji (EX-B2) and flash cupping around Dazhui for 10–15 min, 1×/day | Acupuncture on traditional site | Not Reported | Symptom improvement rate |
Bao [34] | Scapulohumeral periarthritis | 52/52 | 57.1 ± 7.9 56.2 ± 8.6 | 28/24 26/26 | Wet cupping on Jian, Jianqian, Jianhou and Ashi, 1×/week | Acupuncture on Jinayu (LI15), Jianzhen (SI9), Jianliao (SJ14), Jinaqian, Quchi (LI11), Waiguan (SJ5), Yanglingquan (GB34), 30 min, 1×/day | 15 | Symptom improvement rate |
Sha [35] | Scapulohumeral periarthritis | 52/52 | 51.1 ± 5.8 51.3 ± 6.5 | 28/24 29/23 | Wet cupping on Jian, Jianqian, Jianhou and Ashi, 1×/week | Acupuncture on Jinayu (LI15), Jianzhen (SI9), Jianliao (SJ14), Jinaqian, Quchi (LI11), Waiguan (SJ5), Yanglingquan (GB34), 30 min, 1×/day | 15 | Symptom improvement rate |
Liu [36] | Muscles fibrositis | 38/38 | 30–60 | 19/19 23/15 | Flash cupping on tender points and retained for 10–15 min, 1×/day | Electricacupuncture on traditional acupoints. 1×/day | 16 | Symptom improvement rate |
Huang [37] | Soft tissue contusion | 132/132 | 4–69 | 107/157 | Wet cupping on Ashi. 1×/day | Resistance acupuncture on the contusion site | 7 | Symptom improvement rate |
Zhou [38] | Acute lumbar sprain | 26/26 | 41.27 ± 8.76 39.38 ± 8.12 | 9/17 12/14 | Wet cupping on waist area of the bladder meridian for 5 mins, 1×/2 days | Acupuncture on bladder meridian for 30 min, 1×/day | 10 | Symptom improvement rate, temperature difference of body surface |
Wang [39] | Acute ankle joint | 47/73 | 9–60 | 36/37 25/22 | Wet cupping on Ashi, 10 min 1×/2 days | Acupuncture on Ashi or surrounding acupoint, 1×/2 days | 20 | Symptom improvement rate |
Cao [40] | Fibromyalgia | 29/27 | Not reported | Not reported | Cupping for tender points, 3×/week | Acupuncture for tender points, 3×/week | 35 | VAS, SF36, HAMD |
Description of acupoints
Distribution of diseases/conditions
Outcome assessment
Risk of bias assessment
Effect estimates
Results from individual trials
Study ID | Sample size | Disease | Estimate effect | P | Outcomes |
---|---|---|---|---|---|
Zhou [19] | 200 | Cervical spondylosis | MD −1.70, 95% CI −1.94 to −1.46 | P < 0.00,001 | VAS for pain |
Mou [21] | 124 | Cervical spondylotic radiculopathy | MD 0.11, 95% CI −0.78 to 1.00 MD 4.33, 95% CI −3.14 to 11.80 MD 1.59, 95% CI −1.17 to 4.35 | P = 0.81 P = 0.26 P = 0.26 | VAS Neck disability index (physical therapy) CAS |
Wang [25] | 80 | Knee osteoarthritis | RR 1.29, 95% CI 0.32 to 5.19 RD 0.03, 95% CI −0.11 to 0.16 | P = 0.72 P = 0.72 | Symptom improvement rate |
Wang [26] | 171 | Knee osteoarthritis | MD −0.97, 95% CI −1.56 to −0.38 MD −1.35, 95% CI −1.91 to −0.79 MD −1.01, 95% CI −1.87 to −0.15 MD −0.17, 95% CI −0.52 to 0.18 MD −2.92, 95% CI −6.18 to 0,34 MD −4.14, 95% CI −8.49 to 0.21 MD −1.66, 95% CI −2.48 to −0.84 MD −0.35, 95% CI −0.68 to −0.02 MD −4.93, 95% CI −7.97 to −1.89 MD −6.93, 95% CI −11.0 to −12.85 | P = 0.001 P < 0.00001 P = 0.02 P = 0.34 P = 0.08 P = 0.06 P < 0.0001 P = 0.04 P = 0.001 P = 0.0009 | VAS VAS (follow at 4 weeks) WOMAC—pain scores WOMAC—stiff scores WOMAC—difficult of life scores WOMAC —total scores WOMAC—pain scores (follow at 4 weeks) WOMAC—stiff scores (follow at 4 weeks) WOMAC—difficult of life scores (follow at 4 weeks) WOMAC total scores (follow at 4 weeks) |
Wang [29] | 62 | Lumber disk herniation | MD 1.88, 95% CI −0.24 to 4.00 RR 0.89, 95% CI 0.63 to 1.27 RD −0.07, 95% CI −0.31 to 0.16 | P = 0.08 P = 0.53 P = 0.53 | JOA scores Symptom improvement rate |
Zhou [30] | 120 | The third lumber vertebral transverse process syndrome | RR 1.05, 95% CI 0.96 to 1.15 RD 0.05, 95% CI −0.03 to 0.13 MD −1.58,95% CI −2.04 to −1.12 | P = 0.25 P = 0.24 P < 0.00001 | Symptom improvement rate VAS scores |
Zhang [31] | 40 | Postherpetic neuralgia | RR 0.95, 95% CI 0.83 to 1.09 RD −0.05, 95% CI −0.18 to 0.08 MD 0.10, 95% CI −0.51 to 0.70 | P = 0.47 P = 0.44 P = 0.75 | Symptom improvement rate VAS |
Huang [32] | 96 | Postherpetic neuralgia | RR 1.16, 95% CI 1.00 to 1.33 RD 0.13, 95% CI 0.01 to 0.25 MD −1.17, 95% CI −1.67 to −0.67 | P = 0.05 P = 0.04 P < 0.00001 | Symptom improvement rate VAS |
Wu [33] | 407 | Toothache | RR 1.04, 95% CI 1.00 to 1.08 RD 0.03, 95% CI 0.00 to 0.07 | P = 0.03 P = 0.03 | Symptom improvement rate |
Liu [36] | 76 | Muscles fibrositis | RR 1.05, 95% CI 0.96 to 1.15 RD 0.05, 95% CI −0.03 to 0.14 | P = 0.24 P = 0.22 | Symptom improvement rate |
Huang [37] | 264 | Soft tissue contusion | RR 0.99, 95% CI 0.93 to 1.05 RD −0.01, 95% CI −0.06 to 0.05 | P = 0.79 P = 0.79 | Symptom improvement rate |
Zhou [38] | 46 | Acute lumbar sprain | RR 1.09, 95% CI 0.90 to 1.33 RD 0.08, 95% CI −0.10 to 0.25 | P = 0.39 P = 0.38 | Symptom improvement rate |
Wang [39] | 120 | Acute ankle joint | RR 1.18, 95% CI 1.04 to 1.33 RD 0.15, 95% CI 0.04 to 0.25 | P = 0.009 P = 0.005 | Symptom improvement rate |
Cao [40] | 56 | Fibromyalgia | MD −4.06, 95% CI −5.4 to 13.72 MD −5.93, 95% CI −7.89 to 19.75 MD −0.42, 95% CI −4.09 to 4.93 | VAS Quality of life HAMD |