摘要
目的:评价针灸治疗精神分裂症(SZ)的疗效及安全性。方法:检索国内主要医学文献数据库中有关针灸治疗SZ的文献,依据循证医学的原则和方法纳入研究文献,对其进行Meta分析。结果:经过筛选,最终有17篇文献入选。(1)总有效率方面,文献研究结果异质性检验:Chi2=14.26,自由度为16,P=0.58,I2=0%,认为各项研究间具有同质性,故选用固定效应模型进行数据分析;合并后OR值为3.09,95%可信区间为[2.31,4.13],合并效应检验Z=7.61,P<0.000 01,菱形位于直线右侧。(2)不良反应方面,其中二分类变量研究,合并后OR值为0.34,95%可信区间为[0.16,0.75],合并效应检验Z=2.67,P=0.008,菱形位于直线左侧;连续型变量,合并后SMD值为-0.61,95%可信区间为[-0.88,-0.34],合并效应检验Z=4.39,P<0.000 1,菱形位于直线左侧。结论:从国内现有研究报道来看,针灸配合常规抗精神病药物治疗SZ疗效明显优于单独使用抗精神病药物,并且不良反应发生率更低。尚需试验设计严谨、样本量较大的高质量临床研究提供更加可靠的证据。
Objective To evaluate the clinical efficacy and security of acupuncture therapy combined with conventional antipsychotics in the treatment of schizophrenia.Methods We first comprehensively retrieved papers about acupuncture or moxibustion treatment of schizophrenia published from the time of establishment of the database to April of 2017 in Chinese databases such as Chinese National Knowledge Infrastructure(CNKI),Chinese Science and Technology Periodical Database(VIP),Wanfang,and Chinese BioMedical Literature(CBM)by using keywords"acupuncture""moxibustion""acupuncture+moxibustion""acupuncture+medication""electroacupuncture""filiform needle""scalp-acupuncture""auricular acupuncture",etc.Then,according to the principles and methods of evidence-based medicine,papers conformed to the included standards were enrolled to Meta-analysis by using Review Manager 5.3 software.Results A total of 618 studies were identified,with only 17 articles(containing 1 542 patients)conformed to our included standards and analyzed finally.In regard to the total effective rate of acupuncture or moxibustion for schizophrenia,the combined OR=3.09,95% CI(2.31,4.13),the diamond was on the right side of the vertical line(suggesting being effective),OR checked by Ztest(Z=7.61,P<0.000 01).In regard to the untoward effect,the combined OR=0.34,95% CI(0.16,0.75),the diamond was on the left side of the vertical line(suggesting less adverse effects),OR checked by Ztest(Z=2.67,P=0.008).Sensitivity analysis:the combined standardized mean difference(SMD)=-0.61,95% CI(-0.88,-0.34),the diamond was on the left side of the vertical line(suggesting having more profits than simple medication),SMD checked by Ztest(Z=4.39,P<0.000 1).Conclusion Acupuncture and moxibustion combined with conventional antipsychotics is significantly better than that of antipsychotics alone in the treatment of schizophrenia and has less side effects.But,high quality clinical studies with rigorous experimental design and large sample size are needed to provide more reliable evidence.
作者
赵隽乔
马铁明
ZHAO Jun-qiao;MA Tie-ming(School of Acupuncture-moscibustzon and Tuina,Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)
出处
《针刺研究》
CAS
CSCD
北大核心
2018年第12期806-812,共7页
Acupuncture Research
基金
辽宁省高等学校创新团队(No.LT 2015016)
辽宁省针灸养生康复重点实验室建设项目(No.2017)
关键词
针灸
精神分裂症
循证医学
META分析
Acupuncture and moxibustion
Schizophrenia
Evidence-based medicine
Meta analysis
