Clinical Efficacy of Tuina Therapy for Acute Lumbar Sprain: A Bayesian Network Meta-Analysis Based on Randomized Controlled Trials

Jing Chen,1– 4 Songtao Liu,2,3 Zhichao Gong,4 Xiang Feng,1 Wu Li,1 Jiangshan Li1,4 1School of Acupuncture, Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, Hunan, People’s Republic of China; 2College of Medical Imaging Laboratory and Rehabilitation, Xiangnan University, Chenzhou, Hunan, People’s Republic of China; 3Department of Rehabilitation Medicine, The Affiliated Hospital of Xiangnan University, Chenzhou, Hunan, People’s Republic of China; 4Department of Acupuncture, Tuina and Rehabilitation, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, People’s Republic of ChinaCorrespondence: Jiangshan Li; Wu Li, School of Acupuncture, Tuina and Rehabilitation, Hunan University of Chinese Medicine, No. 300, Xueshi Road, Yuelu District, Changsha, Hunan, 410208, People’s Republic of China, Tel +86 13707315642 ; +86 13574851647, Fax +8673188458187, Email [email protected]; [email protected]: Traditional Chinese medicine possesses distinct advantages in the treatment of acute lumbar sprains, and Tuina (Chinese massage) is a commonly employed therapeutic method. This study employed a Bayesian meta-analysis to assess the efficacy and safety of Tuina therapy for acute lumbar sprain with the aim of providing more evidence-based medical substantiation for clinical practice.Patients and Methods: Randomized controlled trials of Tuina therapy for acute lumbar sprains published in CNKI, CSPD, CCD, CBM, PubMed, Embase, Cochrane Library, and Web of Science were searched up to August 7, 2024. The included studies were assessed for the risk of bias using Cochrane’s randomized controlled trial bias risk assessment tool.Results: Eleven studies involving 810 patients were included in this meta-analysis. Two types of interventions were included: Tuina alone and Tuina combined with conventional treatment. The included studies had a low risk of bias. Three outcome indicators were analyzed. The results of the network meta-analysis showed that, compared with conventional treatment, Tuina alone or in combination with other interventions had a significant advantage in terms of efficacy (P < 0.05). The order of the surface under the cumulative ranking curve (SUCRA) was: Tuina (0.79) and Tuina combined with conventional treatment (0.70). Regarding the visual analog scale score, Tuina combined with the other interventions showed significant advantages (P < 0.05). The order of SUCRA was: Tuina combined with conventional treatment (0.80), followed by Tuina alone (0.64). Regarding the modified Japanese Orthopaedic Association scores, Tuina combined with conventional treatment had a significant advantage (P < 0.05). The order of SUCRA was Tuina combined with conventional treatment (0.98), followed by Tuina alone (0.26).Conclusion: The results suggest that Tuina has significant advantages over conventional treatment.Keywords: acute lumbar sprain, Tuina, efficacy, systematic review, Bayesian network meta-analysis