摘要
目的采用网状Meta分析方法评价针刺治疗原发性痛经(PD)的疗效。方法计算机检索PubMed、EMbase、The Cochrane Library(2016年6期)、CBM、CNKI和WanFang Data数据库,搜集针刺方法对比布洛芬、各种针刺方法之间对比治疗PD的随机对照试验(RCT),检索时限均为从建库至2016年7月6日。由2位评价员独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Stata 13.0和WinBugs 1.43软件进行数据分析。结果共纳入56个RCT,包括4 600例PD患者。网状Meta分析结果显示:在临床总有效率方面,单纯针刺、针刺+艾条灸、针刺+隔物灸、温针、电针、电针+温针优于布洛芬;针刺+艾条灸、针刺+隔物灸、温针优于单纯针刺;在改善VAS疼痛评分方面,各干预措施之间差异无统计学意义;在改善痛经症状评分方面,单纯针刺和布洛芬优于针刺+隔物灸。结论 6种不同针刺方法在治疗PD上优于布洛芬,各类针刺疗法也互有优劣,建议结合临床实际情况及中医辨证合理选择。
Objective To assess the effectiveness ofacupunctures in treatment of primary dysmenorrhea by using network meta-analysis. Methods Databases including the PubMed, EMbase, The Cochrane Library （Issue 6, 2016）, CBM, CNKI and WanFang Data were searched for relevant clinical randomized controlled trials （RCTs） comparing acupunctures with ibuprofen or other kinds of acupuncture from inception to July 6th 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using Stata 13.0 and WinBugs 1.43 software. Results A total of 56 RCTs involving 4 600 PD patients were included. The results of network meta-analysis showed that： for the clinical effects： simple acupuncture, acupuncture plus moxamoxibustion, acupuncture plus indirect-moxibustion, electroacupuncture, warm-acupuncture and electroacupuncture plus warm-acupuncture were superior to ibuprofen, acupuncture plus moxa-moxibustion, acupuncture plus indirect- moxibustion and warm-acupuncture were superior to simple acupuncture. For VAS score, there was no significant difference among all treatments. Simple acupuncture and ibuprofen were superior to acupuncture plus indirect-moxibustion in dysmenorrhea symptom scores. Conclusion The included 6 kinds of acupunctures are superior to ibuprofen and different acupunctures have different advantages in the treatment of PD. When selecting treatment regimen, it is better to consider the clinical situation and TCM syndrome differentiation.
出处
《中国循证医学杂志》
CSCD
2017年第10期1212-1223,共12页
Chinese Journal of Evidence-based Medicine
基金
国家自然科学基金项目(编号:81273935)
关键词
针刺
布洛芬
原发性痛经
网状Meta分析
Acupuncture
Ibuprofen
Primary dysmenorrheal
Network meta-analysis
