Acupuncture and/or moxibustion for the treatment of lumbar disc herniation: quality assessment of systematic reviews

Objective: In the current systematic review on acupuncture and/or moxibustion for lumbar disc herniation (LDH), we evaluated the methodology and quality of evidence and reports to provide necessary information for accurate clinical decision-making regarding acupuncture and/or moxibustion for LDH. Methods: From databases such as CBM (Chinese biomedical literature database), VIP (China science and technology journal database), CNKI (China national knowledge infrastructure), WF (Wanfang database), Web of Science, Embase, Medline, and Cochrane Library, systematic reviews on acupuncture and/or moxibustion for LDH were retrieved, and the methodological quality of the literature was evaluated according to the assessment of multiple systematic reviews (AMSTAR) list. Furthermore, the grading of recommendations assessment, development and evaluation (GRADE) system was used to grade the quality of evidence and the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement to evaluate the quality of the report. Results: A total of 18 systematic reviews were included, and the conclusion is that acupuncture and/or moxibustion have some advantages in terms of efficacy and safety with regard to LDH treatment. According to the AMSTAR score, there were 4 high-quality studies, 13 moderate-quality studies, and 1 low-quality study. GRADE showed that quality of evidence such as total effective rate of LDH and VAS was low and that of other forms of evidence was lower. The PRISMA statement showed that 8 articles were in line with 20 or more of the 27 items, and 10 articles were in line with 10-19 of the 27 items. Conclusion: At present, acupuncture and/or moxibustion for LDH has a good curative effect. More importantly, its methodological quality was of moderate level and the report quality was generally good and relatively complete. However, the poor quality of the original research results was reflected in the quality of evidence. More studies are needed to make sure whether acupuncture is more effective than other treatment methods.