Tuina-Focused Integrative Chinese Medical Therapies for Inpatients with Low Back Pain: A Systematic Review and Meta-Analysis

Table 1

Randomized controlled trials evaluating the effect of Tuina-focused integrative Chinese medical therapies (TICMT) for low back pain (LBP).

First authors, yr	Mean duration of LBP	Sample size, mean age (yr)	Duration weeks	Follow-up weeks	Main outcome assessments	TICMT group (EG) intervention*	Control group (CG) intervention*	Main conclusion (mean improvements)
Tuina plus Chinese herbal medicine
Liang (2005) [13]	4–36 mo	49; 44–65	8	24	Pain VAS (0–10); ODI	Tuina; (24 sessions); plus CHM; (3/56 sessions)	Tuina; (24 sessions)	VAS: EG (3.65) > CG (2.65); ODI: EG (12.40) > CG (7.10)
Huang (2008) [14]	1–13 days	100; 42	3	—	Pain VAS (0–10)	Tuina; (25 min/21 sessions); plus CHM; (1/21 sessions)	Tuina; (25 min/21 sessions)	EG (5.78) > CG (4.79)
Su (2008) [15]	NR	120; 40	3 days	—	Pain VAS (0–10)	Tuina; (30 min/3 sessions); plus CHM; (1/3 sessions)	Tuina; (30 min/3 sessions)	EG (4.90) > CG (0.55)
Cai (2010) [16]	NR	96; >16	4	—	Pain VAS (0–10)	Tuina; (30 min/24 sessions); plus CHM; (2/24 sessions)	CHM; (2/24 sessions); plus traction; (15 min/24 sessions)	EG (8.15) > CG (5.99)
Wen (2010) [17]	4–20 days	120; NR	3	—	Pain VAS (0–100)	Tuina plus CHM; (NR)	(1) Tuina (NR); (2) CHM (NR)	EG (21.40) > CG1 (12.20); EG (21.40) > CG2 (11.10)
Zhang (2011) [18]	36 mo	184; 58	5	—	ODI	Tuina; (28 sessions); plus injection CHM; (1/28 sessions)	Tuina; (28 sessions)	EG (51.20) > CG (28.20)
You (2012) [19]	34.8 h	240; 30	1	—	Pain VAS (0–10)	Tuina; (7 sessions); plus CHM; (1/7 sessions)	Tuina; (7 sessions)	EG (7.86) > CG (6.32)
Tuina plus acupuncture
Pang (2006) [20]	9.3 mo	120; 45	2	—	Pain VAS (0–10)	Tuina; (20 min/14 sessions); plus electroacupuncture; (4 AP/14 sessions)	Tuina; (20 min/14 sessions)	EG (5.51) > CG (4.45)
Chen (2007) [21]	15.9 mo	60; 37	2	—	JOA (0–29)	Tuina; (25 min/7 sessions); plus acupuncture; (3–8 AP/8 sessions)	Traction plus infrared radiation; (30 min /14 sessions)	EG (10.83) > CG (8.16)
Liu (2008) [22]	2 days	105; 41	1	4	Pain VAS (0–10)	Tuina; (7 sessions); plus acupuncture; (1 AP/7 sessions)	(1) Tuina (7 sessions); (2) Acupuncture (1 AP/7 sessions)	EG (4.84) > CG1 (4.32); EG (8.74) > CG2 (4.11)
He (2010) [23]	1 day–10 yr	180; 38	2	—	Pain VAS (0–10)	Tuina; (6 sessions); plus electroacupuncture; (10 AP/10 sessions)	Electroacupuncture; (10 AP/10sessions)	EG (3.65) > CG (3.17)
Ke (2011) [24]	>7 days	60; 20–65	7 days	—	Pain VAS (0–10)	Tuina; (7 sessions); plus electroacupuncture; (4–6 AP/7 sessions)	Traction; (7 sessions)	EG (4.53) > CG (3.14)
Yang (2011) [25]	5 yr	100; 41	15 days	—	Pain VAS (0-10)	Tuina; (30 min/15 sessions); plus electroacupuncture; (3–5 AP/7 sessions)	Electromagnetic therapy; (20 min/1 sessions) plus Chinese herbal hot pack; (25 min/15 sessions)	EG (4.70) > CG (1.70)
Zeng (2012) [26]	2.9 yr	100; 49	2-3	12	JOA (0–29)	Tuina; (20 min/14–21 sessions); plus acupuncture; (8-9 AP/14–21 sessions)	Acupuncture; (8-9 AP/14–21 sessions)	EG (12.70) > CG (10.60)
Tuina plus hot pack
Rong (2010) [27]	10.2 mo	40; 52	20 days	—	JOA (0–29)	Tuina; (20 sessions); plus Chinese herbal hot pack; (30 min/40 sessions)	Tuina; (20 sessions)	EG (11.32) > CG2 (5.23)
Yuan (2010) [28]	>6 mo	120; 38	20 days	—	Pain VAS (0–10)	Tuina; (20 sessions); plus hot pack; (360 min/20 sessions)	Tuina; (20 sessions)	EG (3.65) < CG (4.85)
Tuina plus moxibustion
Liu (2010) [29]	1.2 yr	90; 31	4	—	Pain VAS (0–10)	Tuina; (30 sessions); plus moxibustion; (3 AP/30 sessions)	(1) Tuina; (30 sessions); (2) Moxibustion; (3 AP/30 sessions)	EG (3.51) > CG1 (3.21); EG (3.51) > CG2 (1.79)
Tuina plus more than one Chinese medical therapy
Zhou (2009) [30]	3 days–10 yr	100; 44	10 days	—	JOA (0–29)	Tuina; (10 sessions); plus traction; (30–60 min/20 sessions); and Chinese herbal; hot pack; (30–45 min/20 sessions)	Traction; (30–60/20 sessions) plus Chinese herbal hot; Pack; (30–45 min/20 sessions)	EG (19.82) > CG2 (9.46)
Wang (2011) [31]	1.2 yr	60; 45	30 days	—	Pain VAS (0–10)	Tuina; (30 sessions); plus acupuncture; (7 AP/30 sessions); and CHM (NR)	Tuina; (30 sessions)	EG (5.98) > CG (3.40)
Chen (2012) [32]	—	103; —	6	—	JOA (0–29)	Tuina; (30 min/42 sessions) plus acupuncture; (10 AP/42 sessions); and moxibustion; (3/42 sessions)	Tuina; (30 min/42 sessions)	EG (11.1) > CG2 (4)

VAS: Visual analog scale; ODI: the oswestry disability index; CHM: Chinese herbal medicine; NR: no reported; JOA: Japanese orthopaedic association score for low back pain; yr: year; mo: month; h: hour; AP: acupuncture point.
*Intervention dose: number of intervention time/number of sessions, number of acupuncture points/number of sessions, or number of Chinese herbal medicine every day/number of sessions.