Scraping therapy for knee osteoarthritis: a systematic review and Meta-analysis

doi:10.19852/j.cnki.jtcm.20240626.001

Abstract

Abstract:

OBJECTIVE: To systematically evaluate the efficacy of scraping therapy on knee osteoarthritis (KOA).

METHODS: A computerized search was conducted in several databases, including PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wanfang, and Chinese BioMedical Literature Database, from the establishment date of these databases to April 9, 2023. Randomized controlled trials (RCTs) on scraping therapy for KOA were collected in accordance with the “Participants-Intervention-Control-Outcome-Study design” criteria. The methodological evaluation of the included studies was carried out using RoB 2.0, and Meta-analysis was conducted using RevMan. The Grades of Recommendations Assessment, Development and Evaluation (GRADE System) was applied to grade the quality of evidence.

RESULTS: A total of 12 RCTs with 997 subjects were included in the Meta-analysis. Results indicated that compared with the control group, the scraping therapy treatment group exhibited increased Lysholm scores [mean difference (MD) = 4.96, 95% confidence intervals (CI) (3.18, 6.74), P < 0.000 01] and Hospital for Special Surgery scores [MD= 8.35, 95% CI(3.92, 12.78), P =0.0002] and decreased visual analog scale scores [MD = -2.11, 95% CI(-3.79, -0.44), P =0.01] and Western Ontario and McMaster University Osteoarthritis Index scores [MD= -6.77, 95% CI(-8.99, -4.56), P < 0.000 01)]. The quality of evidence obtained in this Meta-analysis was low according to the GRADE system.

CONCLUSION: The available evidence suggests that scraping therapy may have certain clinical efficacy in the treatment of KOA. However, further high-quality RCTs are needed to confirm the findings.

Key words: osteoarthritis, knee, scraping, Meta-analysis, systematic review

CHEN Dandan, JIN Qianhong, SHEN Yuanjuan, WANG Qing, DAI Zhengxiang. Scraping therapy for knee osteoarthritis: a systematic review and Meta-analysis[J]. Journal of Traditional Chinese Medicine, 2024, 44(4): 633-641.

Figures/Tables 5

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Study	Sample size (n) (T/C)	Age (years)	Gender (male/ female)	Duration	TCM syndrome pattern	Intervention measure		Frequency /times or duration of scraping	Outcome
Study	Sample size (n) (T/C)	Age (years)	Gender (male/ female)	Duration	TCM syndrome pattern	T	C	Frequency /times or duration of scraping	Outcome
Deng YL et al 2022 ²⁷	35/35	T: 64.7±4.7 C: 64.5±4.8	T: 15/20 C: 13/22	T: 3.26±1.02 yr C:3.43±1.05 yr	n.r.	Holographic scraping+ Celecoxib capsules	Celecoxib capsules	1 d, 14 times	② ④
Zhu WT et al 2022 ²⁸	25/25	T: 58.88±3.47 C: 56.96±3.52	T: 7/18 C: 8/17	T: 12.84 ± 1.02 m C: 16.32± 1.02 m	n.r.	Copper scraping+ Haohuo needle	Haohuo needle	3 to 5 d, 5 times	④ ⑧
Guo YG et al 2021 ²⁹	50/50	T: 48.26±1.95 C: 48.43±2.14	T: 29/21 C: 28/22	n.r.	liver and kidney deficiency	Scraping+Routine care	Acupuncture+ routine care	1 week, 10 times	② ③
Xu FY et al 2021 ³⁰	30/30	T: 52.83±5.06 C: 53.26±4.03	T: 16/14 C: 18/12	T: 3.59±1.14 yr C: 3.61±1.17 yr	cold and stasis obstruction collateral	Hufu copper scraping + Symptomatic care	Symptomatic care	3 to 5 d, 1 month	① ② ⑤
Bao SY et al 2020 ³¹	24/24	T: 64.97±6.23 C: 65.37±6.15	T: 12/12 C: 10/14	T: 2.10±0.38 yr C: 1.99±0.23 yr	n.r.	Hufu copper scraping+ Health care	Routine clinical treatment+health care	1 week, 12 times	②
Zheng JX et al 2019 ³²	80/80	T: 51.58±9.53 C: 54.13±10.16	T: 22/18 C: 22/18	T: 3.68±2.13 yr C: 3.48±2.45 yr	n.r.	Hufu copper scraping+ Scraping + routine drug therapy and care	Routine drug therapy and care	5-7 d, 12 times	② ③
Wei JR et al 2018 ³³	40/40	T: 67.00±10.54 C: 66.30±11.71	T: 16/24 C: 18/22	n.r.	n.r.	Self-functional exercise	Moxibustion+self-functional exercise	3-5 d, 4 times	②
Su LF et al 2017 ³⁴	27/27	n.r.	T: 10/11 C: 7/20	n.r.	n.r.	Scraping+ Moxibustion	Moxibustion	3 d, 10 times	①
Chen YH 2015 ³⁵	30/30	T: 55.5±4.5 C: 54.6±5.1	T: 9/21 C: 10/20	n.r.	liver and kidney deficiency	Scraping	Acupuncture	3 d, 10 times	② ②
Qiu JM et al 2013 ³⁶	30/30	T: 55-62 C: 56-64	T: 7/23 C: 8/22	T: 2-5 yr C: 2-5 yr	n.r.	Scraping+ Shenmai needle	Shenmai needle	3 d, 15 times	⑤
Bian XF 2012 ³⁷	98/102	T: 48-82 C: n.r.	T: 30/68 C: n.r.	T: 3 m-35 yr C: n.r.	n.r.	Scraping+ Dahuoluo Pill	Acupuncture+Dahuoluo Pill	3 d, 5 times	①
Liu ZD et al 2011 ³⁸	30/30	T: 60.57±1.79 C: 61.10±1.98	T: 12/18 C: 13/17	T: 6.39±1.44 yr C: 6.59±0.95 yr	n.r.	Scraping+ Glucosamine sulfate capsules	Glucosamine sulfate capsules	1 week, twice	③

Study	Sample size (n) (T/C)	Age (years)	Gender (male/ female)	Duration	TCM syndrome pattern	Intervention measure		Frequency /times or duration of scraping	Outcome
Study	Sample size (n) (T/C)	Age (years)	Gender (male/ female)	Duration	TCM syndrome pattern	T	C	Frequency /times or duration of scraping	Outcome
Deng YL et al 2022 ²⁷	35/35	T: 64.7±4.7 C: 64.5±4.8	T: 15/20 C: 13/22	T: 3.26±1.02 yr C:3.43±1.05 yr	n.r.	Holographic scraping+ Celecoxib capsules	Celecoxib capsules	1 d, 14 times	② ④
Zhu WT et al 2022 ²⁸	25/25	T: 58.88±3.47 C: 56.96±3.52	T: 7/18 C: 8/17	T: 12.84 ± 1.02 m C: 16.32± 1.02 m	n.r.	Copper scraping+ Haohuo needle	Haohuo needle	3 to 5 d, 5 times	④ ⑧
Guo YG et al 2021 ²⁹	50/50	T: 48.26±1.95 C: 48.43±2.14	T: 29/21 C: 28/22	n.r.	liver and kidney deficiency	Scraping+Routine care	Acupuncture+ routine care	1 week, 10 times	② ③
Xu FY et al 2021 ³⁰	30/30	T: 52.83±5.06 C: 53.26±4.03	T: 16/14 C: 18/12	T: 3.59±1.14 yr C: 3.61±1.17 yr	cold and stasis obstruction collateral	Hufu copper scraping + Symptomatic care	Symptomatic care	3 to 5 d, 1 month	① ② ⑤
Bao SY et al 2020 ³¹	24/24	T: 64.97±6.23 C: 65.37±6.15	T: 12/12 C: 10/14	T: 2.10±0.38 yr C: 1.99±0.23 yr	n.r.	Hufu copper scraping+ Health care	Routine clinical treatment+health care	1 week, 12 times	②
Zheng JX et al 2019 ³²	80/80	T: 51.58±9.53 C: 54.13±10.16	T: 22/18 C: 22/18	T: 3.68±2.13 yr C: 3.48±2.45 yr	n.r.	Hufu copper scraping+ Scraping + routine drug therapy and care	Routine drug therapy and care	5-7 d, 12 times	② ③
Wei JR et al 2018 ³³	40/40	T: 67.00±10.54 C: 66.30±11.71	T: 16/24 C: 18/22	n.r.	n.r.	Self-functional exercise	Moxibustion+self-functional exercise	3-5 d, 4 times	②
Su LF et al 2017 ³⁴	27/27	n.r.	T: 10/11 C: 7/20	n.r.	n.r.	Scraping+ Moxibustion	Moxibustion	3 d, 10 times	①
Chen YH 2015 ³⁵	30/30	T: 55.5±4.5 C: 54.6±5.1	T: 9/21 C: 10/20	n.r.	liver and kidney deficiency	Scraping	Acupuncture	3 d, 10 times	② ②
Qiu JM et al 2013 ³⁶	30/30	T: 55-62 C: 56-64	T: 7/23 C: 8/22	T: 2-5 yr C: 2-5 yr	n.r.	Scraping+ Shenmai needle	Shenmai needle	3 d, 15 times	⑤
Bian XF 2012 ³⁷	98/102	T: 48-82 C: n.r.	T: 30/68 C: n.r.	T: 3 m-35 yr C: n.r.	n.r.	Scraping+ Dahuoluo Pill	Acupuncture+Dahuoluo Pill	3 d, 5 times	①
Liu ZD et al 2011 ³⁸	30/30	T: 60.57±1.79 C: 61.10±1.98	T: 12/18 C: 13/17	T: 6.39±1.44 yr C: 6.59±0.95 yr	n.r.	Scraping+ Glucosamine sulfate capsules	Glucosamine sulfate capsules	1 week, twice	③

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