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| Efficacy of traditional Chinese medicine external treatment for flexor tendon stenosing tenovaginitis： A network Meta-analysis |
| Hits 163 Download times 73 Received:April 25, 2026 |
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| DOI
10.11656/j.issn.1672-1519.2026.10.06 |
| Key Words
network Meta-analysis;stenosing tenosynovitis of the flexor tendons;external treatment methods in traditional Chinese medicine |
| Author Name | Affiliation | E-mail | | WANG Xinyue | Beijing University of Chinese Medicine, Beijing 100102, China
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100029, China | | | YU Ximing | Beijing University of Chinese Medicine, Beijing 100102, China | | | CHEN Yanbai | Beijing University of Chinese Medicine, Beijing 100102, China | | | HE Mingjiang | Beijing University of Chinese Medicine, Beijing 100102, China
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100029, China | arthrodoc@163.com |
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| Abstract
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| [Objective] To evaluate the clinical efficacy of different traditional Chinese medicine（TCM）external therapies for flexor tendon stenosing tenosynovitis using network Meta-analysis（NMA）. [Methods] Databases including PubMed，Embase，The Cochrane Library，China National Knowledge Infrastructure（CNKI），VIP，and Wanfang Database were searched for randomized controlled trials （RCTs）on TCM external therapies for treating stenosing tenosynovitis of the flexor tendons. The search period spanned from database inception to October 24，2025. Literature was retrieved using defined search terms and strategies，followed by initial and full-text screening based on inclusion and exclusion criteria. Quality assessment and data extraction were performed，with statistical analysis conducted using Review Manager 5.4 and Stata 15.1. [Results] A total of 49 studies involving 5 379 patients were included after screening. These studies encompassed nine intervention methods：acupuncture，acupuncture knife therapy，warm acupuncture，herbal external wash，medicated plaster application，massage therapy，fire needle therapy，moxibustion，and local injection therapy. Regarding clinical efficacy rates，acuproctotherapy，warm acupuncture，moxibustion，acupuncture，and fire needle therapy demonstrated superior outcomes compared to nerve block therapy. In indirect comparisons among TCM external therapies：warm acupuncture outperformed acuproctotherapy and herbal external wash；moxibustion outperformed acupuncture；and fire needle therapy outperformed massage. Regarding VAS scores，needle knife and warm acupuncture demonstrated more significant efficacy than nerve block therapy. In indirect comparisons among TCM external therapies：warm acupuncture outperformed herbal external wash，medicated plaster application，acupuncture，and needle knife；needle knife outperformed herbal external wash；and fire needle outperformed herbal external wash. The cumulative probability under the receiver operating characteristic curve（SUCRA）revealed：for treatment efficacy， the top three interventions ranked by probability were warm acupuncture，acupuncture knife therapy，and moxibustion；for improving VAS scores，the top three interventions ranked by probability were warm acupuncture，acupuncture knife therapy，and acupuncture. [Conclusion] TCM external therapies effectively treat flexor tendon stenosing tenosynovitis and improve VAS scores. In clinical practice，appropriate TCM external treatment protocols can be selected based on the disease stage and patient condition. Based on SUCRA results，warm acupuncture ranked relatively higher in clinical efficacy rates，VAS score improvement，and treatment of patients with disease duration <6 months，demonstrating certain therapeutic advantages. However，due to limitations in the quality and quantity of included literature as well as evidence quality，careful selection should be made in clinical application based on individual patient circumstances. These conclusions require further validation through multicenter，large-sample randomized controlled trials to provide higher-quality evidence support for clinical practice. |
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