MOXIBUSTION AND FIER NEEDLE ACUPUNCTURE FOR GOUTY ARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: To assess the effectiveness of moxibustion and fire needle acupuncture for the treatment of gouty arthritis (GA) by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: Seven electronic databases were searched from inception to August 2022 for all RCTs of moxibustion or fire needle acupuncture for GA treatment. Two investigators evaluated the quality of the included studies and extracted data independently. All statistical analyses were performed by RevMan 5.3. Results: Ten RCTs with 653 patients were included after the final screening. The meta-analysis showed that compared with Western medicine, both moxibustion and fire needle acupuncture significantly improved the total effective rate (RR=1.16, 95% CI 1.10-1.23, P<0.00001) and the Comprehensive Joint Swelling and Pain (CSJSP) (RR=3.62, 95% CI 2.99-4.25, P<0.00001) and significantly decreased the uric acid level (RR=19.34, 95% CI 2.07-36.62, P=0.03). Subgroup analyses based on the intervention type showed that either moxibustion or fire needle acupuncture significantly improved the total effective rate and the CSJSP and reduced uric acid levels; however, moxibustion (MD=27.70, 95% CI 19.85-35.54, P<0.00001) was significantly better than fire-acupuncture (MD=-1.05, 95% CI -14.39-12.29, P=0.88) in lowering uric acid levels. Conclusion: This study showed that both moxibustion and fire needle acupuncture are effective for GA patients. Considering the limitations of the included studies such as language bias and small sample size, rigorously designed and high-quality RCTs should be conducted to further evaluate the effectiveness and safety of moxibustion and fire needle acupuncture in treating GA.