主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2017, Vol. 40 ›› Issue (5): 428-435.doi: 10.3969/j.issn.1006-2157.2017.05.012

• 临床研究 • 上一篇    下一篇

针灸治疗视神经萎缩有效性系统评价及网状Meta分析*

卜正祥, 罗晓舟, 唐纯志#   

  1. 广州中医药大学针灸康复临床医学院 广东 510000
  • 收稿日期:2016-09-20 出版日期:2017-05-30 发布日期:2017-05-30
  • 通讯作者: 唐纯志,男,博士,教授,博士生导师,研究方向:针灸治病机理研究,E-mail:jordan664@163.com
  • 作者简介:卜正祥,男,在读硕士生
  • 基金资助:
    *国家重点基础研究发展计划 (973计划)项目(No. 2012CB518504)

Systematic review and network Meta-analysis on effectiveness of acupuncture-moxibustion in treatment of optic atrophy*

BU Zhengxiang, LUO Xiaozhou, TANG Chunzhi#   

  1. Clinical School of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangdong 510000, China
  • Received:2016-09-20 Online:2017-05-30 Published:2017-05-30
  • Supported by:
    Project sponsored by National Key Basic Research Development Plan (No. 2012CB518504)

摘要: 目的 采用基于频率统计法数据填补策略的网状Meta模型分析评价针灸治疗视神经萎缩的临床疗效。方法 计算机检索Cochrane Library、PubMed、EMbase、AMED、Nature、Science Online、WorldSciNet、中国生物医学文献光盘数据库(CBM)、中国期刊全文数据库(CNKI)、万方资源数据库建库至2016年6月收录的随机对照试验/半随机对照试验(RCT/CCT)文献,由2名研究者按照Cochrane手册5.1.0标准对每项纳入的研究进行质量和偏倚风险评估。结果 共纳入16项研究、1 369例样本。网状Meta分析结果显示,每种治疗方法疗效“最佳”的可能性分别是:西药(10.5%)、针刺(5.9%)、针刺+艾灸(4.4%)、耳穴+中药(4.7%)、电针(8.0%)、针刺+中西药(4.9%)、艾灸+西药(3.2%)、电针+中西药(4.3%)、中西药(10.1%)、中药(6.7%)、针刺+西药(3.4%),西药疗效最佳。针刺结合西药相较于单纯使用西药具有优势(P<0.05)。由于所纳入文献均未描述不良情况的发生,使得安全性评价无法确实得出。对于本病针灸治疗机制的现代医学研究相对较少,尚无法对其现代医学机制作出评判。结论 西药、中西药、电针为治疗本病的最佳疗法可能性大,但确切的结论尚需要高质量的临床研究进一步验证。

关键词: 视神经萎缩, 针灸, 网状Meta分析

Abstract: Objective To analyze the curative effect of acupuncture-moxibustion on optic atrophy by applying network Meta-analysis model based on frequency-statistic data filling strategy. Methods The databases of Cochrane Library, PubMed, EMbase, AMED, Nature, Science Online, WorldSciNet, CBM, CNKI and WanFang Database were retrieved with computer for collecting RCT/CCT literature from database establishing time to Jun. 2016. The review on quality and bias risk of every included study were conducted by 2 researchers according to 5.1.0 standard in Cochrane Handbook. Results There were totally 16 studies involving 1 369 samples included. The results of network Meta-analysis showed that the possibility of the best curative effect of each therapy was respectively as follows: Western drug (10.5%), acupuncture (5.9%), acupuncture+moxibustion (4.4%), ear acupoints+ Chinese medications (4.7%), electro-acupuncture (8.0%), acupuncture+Chinese and Western medications (4.9%), moxibustion+Western medications (3.2%), electro-acupuncture+ Chinese and Western medications (4.3%), Chinese and Western medications (10.1%), Chinese medications (6.7%) and acupuncture+Western medications (3.4%). The results indicated that the curative effect of Western medications was the best. Acupuncture+Western medications had advantages compared with only Western medications, and difference in odds ratio had statistical significance. In terms of safety, the safety evaluation could not be confirmed because none of the included literature described the occurrence of adverse events. The modern medical studies on the mechanism of acupuncture in treatment of optic atrophy were relatively less, so it was unable to judge the modern medical mechanism. Conclusion Western medications, Chinese and Western medications and electro-acupuncture may be the best therapies for optic atrophy, but the exact conclusion still needs to be verified further by high-quality clinical researches.

Key words: optic atrophy, acupuncture-moxibustion, network Meta-analysis

中图分类号: 

  • R246