摘要
目的基于时间针灸学理论探讨时间参数对温针灸治疗实证PD疗效的影响。方法CNKI、WanFang、VIP、CBM、PubMed、Embase、Cochrane Library、Web of science等数据库中检索温针灸治疗实证原发性痛经的随机对照试验。对纳入的论文进行数据提取和质量评价。采用Rev Man 5.3和stata 16软件进行Meta分析。结果(1)共有20项研究符合要求,19篇有效率为结局指标的研究,与对照组比较,温针灸组临床有效率明显高于对照组,且具有统计学意义[OR=5.53,95%CI(3.90,7.84),P<0.00001];(2)两组在痛经症候积分方面、VAS评分改善方面,存在异质性,但是结果具有统计学意义(P<0.00001);(3)时间参数:不同介入时机之间比较(P=0.63)、不同施灸时间之间比较(P=1.00)、不同间隔时间之间比较(P=0.58)、不同治疗疗程之间比较(P=0.96)、不同治疗频次之间比较(P=0.69)、不同灸量之间比较(P=0.89),各因素对温针灸治疗实证原发性痛经疗效的影响均无统计学意义。结论温针灸治疗实证原发性痛经疗效明显优于对照组,但是各个时间因素对温针灸的疗效影响无明显差别,临床上温针灸治疗实证PD的可供参考的时间方案为:经前(5±2)d介入治疗,每日1次或隔日1次均可,每次留针30 min,针刺得气后施灸20~30 min,每个月经周期治疗频次为5~7次,每次灸量2~3壮为宜,共治疗3个月经周期。但是,由于现有随机对照试验的数量较少且质量偏低,具有局限性,且本研究均为单个因素探讨,对温针灸积累因素未进行整体研究,未进行变量控制,建议今后可以统一控制以研究单一变量,且不拘泥于单个变量的优化,而注重整体最佳方案的调配,同时扩大样本量。
Objective Based on the theory of time acupuncture and moxibustion,the effect of time parameters on the therapeutic effect of warm acupuncture on sthenia syndrome primary dysmenorrhea was discussed.Methods CNKI,WanFang,VIP,CBM,PubMed,EMBASE,Cochrane Library,Web of science and other databases were searched for randomized controlled trials of warm acupuncture in the treatment of primary dysmenorrhea.Data extraction and quality evaluation were carried out for the papers that met the selection criteria.Meta analysis was performed using Rev man 5.3 and Stata 16 software.Results(1)A total of 20 studies met the requirements,and 19 studies with effective rate as the outcome index,compared with the control group,the clinical effective rate of warm acupuncture group was significantly higher than that of the control group,and had statistical significance[OR=5.53,95%CI(3.90,7.84),P<0.00001].(2)There was heterogeneity in dysmenorrhea syndrome score and VAS score improvement of the two groups,but the results were statistically significant(P<0.00001).(3)Time parameters:comparison between different intervention time(P=0.63),different moxibustion time(P=1.00),different interval time(P=0.58),different treatment courses(P=0.96),and different treatment frequency compared with(P=0.69)and different amount of moxibustion(P=0.89),there was no significant difference in the effect of warming acupuncture on sthenia syndrome primary dysmenorrhea.Conclusion The therapeutic effect of warm acupuncture and moxibustion on sthenia syndrome primary dysmenorrhea was significantly better than that of the control group,but there was no significant difference in the effect of warm acupuncture on the curative effect of warm acupuncture.The reference time scheme of warm acupuncture in the treatment of empirical PD was as follows:interventional therapy(5±2)days before menstruation,once a day or once every other day,with 30 minutes for each time,after acupuncture,moxibustion was applied for 20-30 min.The frequency of treatment in each menstrual cycle was 5-7 times,and the appropriate amount of moxibustion was 2-3 cones.A total of 3 menstrual cycles were treated.However,due to the limited number and low quality of the existing randomized controlled trials,and this study was a single factor discussion,there was no overall study on the accumulation factors of warm acupuncture and moxibustion,and there was no variable control.It was suggested that we can study single variable by unified control in the future,and not stick to the optimization of single variable,but pay attention to the allocation of the overall best scheme and expand the sample size.
作者
柴美伶
王昕
CHAI Meiling;WANG Xin(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)
出处
《辽宁中医药大学学报》
CAS
2021年第5期131-137,共7页
Journal of Liaoning University of Traditional Chinese Medicine
基金
中医药行业科研专项基金项目(201407001-7)
国家中医药管理局中医临床研究基地业务建设科研专项(JDZΧ2015064)
辽宁省中医药临床学(专)科能力建设资金资助项目(2018-125)。
关键词
温针灸
原发性痛经
实证
META分析
时间参数
warming acupuncture
primary dysmenorrhea
sthenia syndrome
meta-analysis
time parameters
