Fu's subcutaneous needling therapy for intervertebral disk displacement: a systematic review and meta-analysis

Intervertebral disk displacement (IDD) significantly impairs quality of life and overall health. The incidence of IDD has been increasing due to rising social pressures. Fu's subcutaneous needling, an advanced acupuncture technique, demonstrates several advantages over traditional filiform needles. However, its clinical efficacy remains a subject of debate. This study employed a meta-analysis approach to comprehensively evaluate the therapeutic efficacy of Fu's subcutaneous needling for IDD.

A systematic search was conducted across multiple databases, such as PubMed, EMbase, Cochrane Library, Web of Science, CNKI database, Wanfang database, VIP database, and Chinese Biomedical Literature Service System (CBM), for randomized controlled trials (RCTs) on Fu's subcutaneous needling therapy for IDD published up to 10 March 2025. Meta-analysis was performed using RevMan 5.4 software.

A total of 32 RCTs meeting the criteria were finally included, involving 2,778 subjects. The meta-analysis evidence indicated that the clinical total effective rate of Fu's subcutaneous needling group was significantly higher than that of the control group (RR = 1.16, 95% CI [1.11, 1.20], p < 0.05, I ² = 50%). In terms of pain relief: (VAS score: MD = -1.69, 95% CI [-2.59, -0.78], p < 0.05, I2 = 99%), improvement in lumbar function (JOA score: MD = 3.97, 95% CI [2.61, 5.34], p < 0.05, I2 = 92%), and (ODI index: MD = -7.50, 95% CI [-8.79, -6.21], p < 0.05, I2 = 92%), the Fu's subcutaneous needling group demonstrated superior intervention effects in all aspects. Subgroup analysis showed that different control measures (such as filiform needles and electroacupuncture) and treatment courses might be sources of heterogeneity. The GRADE evaluation indicated that, due to high heterogeneity and sample size limitations, the quality of evidence for the main outcome was moderate to very low. Sensitivity analysis suggested that the combined effect value was stable, and the publication bias assessment indicated that the possibility of significant bias was low.

Fu's subcutaneous needling therapy demonstrates good efficacy and safety for IDD. Although this study supports its clinical application, the quality of the included studies is relatively low. Therefore, more high-quality, multicenter RCTs are warranted in the future to further validate its therapeutic efficacy.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251001904.