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

Table 3

Forest plots of the effect of Tuina-focused integrative Chinese medical therapies (TICMT) on pain of in-patients with low back pain. Box in the line for each study: the mid-point of the box represents the mean effect estimate, which area shows the weight given to the study, and the line represents the confidence intervals of the mean effect estimate. The diamond below these studies represents the overall effect. The vertical line, which corresponds to the value 0 in the plot, is the line of no effect. Note that it says favours TICMT to the right of the vertical line and favours control therapy to the right of the vertical line.

Study or subgroup	TICMT			Control therapy				Std. mean difference	Std. mean difference
	Mean	SD	Total	Mean	SD	Total	Weight	IV, random, 95% CI	IV, random, 95% CI
1.1.1 Tuina plus Chinese herbal medicine
Cai 2010 [16]	8.15	1.14	48	5.99	1.22	48	5.8%	1.81 (1.34, 2.29)
Huang 2008 [14]	5.78	3.07	50	4.79	2.95	50	6.0%	0.33 (−0.07, 0.72)
Liang 2005 [13]	3.65	2.09	25	2.65	2.12	24	5.6%	0.47 (−0.10, 1.04)
Su and Lei 2008 [15]	4.9	2.02	60	0.55	2.52	60	5.9%	1.89 (1.46, 2.33)
Wen 2010 [17]	21.4	7.95	40	12.2	8.89	40	5.8%	1.08 (0.61, 1.55)
Wen 2010 [17]	21.4	7.95	40	11.1	7.25	40	5.8%	1.34 (0.85, 1.83)
You and Zhou 2012 [19]	7.86	1.22	120	6.32	1.23	120	6.2%	1.25 (0.98, 1.53)
Subtotal (95% CI)			383			382	41.3%	1.17 (0.75,  1.60)
Heterogeneity: Tau^2 = 0.28; Chi^2 = 42.05, df = 6 (P < 0.00001); 𝐼^2 = 86%
Test for overall effect: Z = 5.38 (P < 0.00001)
1.1.2 Tuina plus acupuncture
He et al. 2010 [23]	3.65	1.62	81	3.17	1.64	79	6.2%	0.29 (−0.02, 0.60)
Ke and Li 2011 [24]	4.53	1.02	60	3.14	1.09	60	6.0%	1.31 (0.91, 1.70)
Liu et al. 2008 [22]	4.84	1.19	35	4.32	1.05	35	5.8%	0.46 (−0.02, 0.93)
Liu et al. 2008 [22]	4.84	1.19	35	4.11	1.27	35	5.8%	0.59 (0.11, 1.07)
Pang et al. 2006 [20]	5.51	1.58	60	4.45	1.55	60	6.1%	0.67 (0.30, 1.04)
Yang et al. 2011 [25]	4.7	0.95	50	1.7	1.49	50	5.7%	2.38 (1.87, 2.90)
Subtotal (95% CI)			321			319	35.7%	0.94 (0.38,  1.50)
Heterogeneity: Tau^2 = 0.44; Chi^2 = 55.70, df = 5 (P < 0.00001); 𝐼^2 = 91%
Test for overall effect: Z = 3.27 (P = 0.001)
1.1.3 Tuina plus hot pack
Yuan et al. 2010 [28]	3.65	1.78	60	4.85	1.3	60	6.1%	−0.77 (−1.14, −0.39)
Subtotal (95% CI)			60			60	6.1%	−0.77 (−1.14,  −0.39)
Heterogeneity: not applicable
Test for overall effect: Z = 4.04 (P < 0.0001)
1.1.4 Tuina plus moxibustion
Liu 2010 [29]	3.51	2.33	30	1.79	2.31	30	5.7%	0.73 (0.21, 1.26)
Liu 2010 [29]	3.51	2.33	30	3.21	2.44	30	5.8%	0.12 (−0.38, 0.63)
Subtotal (95% CI)			60			60	11.5%	0.42 (−0.17,  1.02)
Heterogeneity: Tau^2 = 0.12; Chi^2 = 2.67, df = 1 (P < 0.10); 𝐼^2 = 63%
Test for overall effect: Z = 1.40 (P = 0.16)
1.1.5 Tuina plus more than one Chinese medical therapy
Wang et al. 2011 [31]	5.98	1.42	30	3.4	1.72	30	5.6%	1.61 (1.03, 2.20)
Subtotal (95% CI)			30			30	5.6%	1.61 (1.03,  2.20)
Heterogeneity: not applicable
Test for overall effect: Z = 5.38 (P < 0.00001)
Total (95% CI)			854			851	100.0%	0.91 (0.54,  1.28)
Heterogeneity: Tau^2 = 0.55; Chi^2 = 202.56, df = 16 (P < 0.00001); 𝐼^2 = 92%
Test for overall effect: Z = 4.83 (P = 0.00001)