摘要
目的:评价针灸治疗变应性鼻炎的有效性和安全性。方法:按照循证医学的要求,以变应性鼻炎、过敏性鼻炎、鼻鼽、针灸、随机对照试验、随机、对照(中、英文)为检索词检索国内外相关数据库,以随机对照临床试验为纳入标准,治疗组为针刺疗法,对照组为假针刺或药物治疗;以鼻症状评分、生活质量评分、变应性鼻炎临床缓解持续的时间;改善症状的有效率为第一终点指标;以缓解药物的使用评分、血清特异性IgE检测、鼻分泌物及血嗜酸性粒细胞计数、副反应情况作为第二终点指标。结果:共纳入8个临床研究。对其中3篇以鼻症状评分量表作为结局指标的文献采用Stata11.0进行Meta分析。对于其余终点结局指标的选择,各研究间存在较大差异,且部分文献存在不同程度上的报道缺陷,故对其余的这些结局指标仅进行了定性分析。结果:以鼻症状评分量表为结局指标的3个研究中,经合并后标准化均数差(SMD)为-0.642,95%可信区间(95%CI)为-0.942^-0.360,森林图中菱形位于无效竖线左侧,表明针灸能降低变应性鼻炎的鼻症状评分量表分值,改善症状;对文献的定性研究表明针灸治疗变应性鼻炎的有效率与对照组相似;对于血清特异性IgE的改善,仅两篇文献报道,并得出了相反的结论 ;仅一篇文献报道了针灸治疗改善嗜酸性粒细胞的情况。此外,研究表明针灸治疗组和对照组的缓解药物使用情况无差异,无严重不良反应发生。结论:针灸治疗能改善变应性鼻炎的症状,无明显不良反应;但对于疾病实验室指标的改善还需更多的大样本临床随机对照研究进行验证;在国内开展高质量、内在真实性好的相关随机对照试验非常必要。
Objective ： To examine the efficacy and safety of acupuncture in the treatment of allergic rhinitis. Method ： A search was performed to gather randomized controlled trials ahout acupuncture treatment for allergic rhinitis in PubMed, ASP （ Academic Source Premier ） of ECSCO, MEDLINE, China National Knowledge Infrastructure （ CNKI ）, Wanfang database, and the database of Chinese Clinical Trial Registry as well as the database of scientific dissertation and conference papers. The randomized controlled trials which involved acupuncture treatment for allergic rhinitis and met the inclusion criteria were selected. Then assessment was conducted for the qualities of these trials, interventions, outcome measurements and results. Results ： There were 8 clinical trials selected. A Meta-analysis was performed on a total of 204 patients involved in 3 papers in which nasal symptoms scores had been used as lhe primary outcome measurements. The SMD （ standardized mean difference ）was -0.642,95%CI （ confidence interval ）was -0.942--0.360. The rhombus located on the leftward of the null line in the forest plots. This indicated that acupuncture could decrease nasal symptoms and be benefit to relieve allergic rhinitis. Because of clinical differences and various outcome measures, other data was not combined in Meta-analysis, and a descriptive analysis was performed. The result indicated a positive effect of acupuncture in improving the efficiency of allergic rhinitis. And two trials reported acupuncture was benefit for improvement of serum special IgE. Only one trial referred to eosinophils. Conclusions ： It suggested that acupuncture is an effective treatment for allergic rhinitis and there is no severe side effect. But there is still a need for more randomized controlled clinical trials in which correlated laboratory indexes should he reported besides symptoms. Moreover, trials with high oualitv to assure high internal validitv are extracted to he conducted in China.
出处
《辽宁中医药大学学报》
CAS
2013年第3期51-57,共7页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家自然科学基金资助项目(81273985)
关键词
针灸
变应性鼻炎
随机对照试验
系统评价
acupuncture
allergic rhinitis
randomized controlled trial
systematic revmw
