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.