摘要
目的:系统评价温针灸及其联合疗法治疗类风湿关节炎的临床效果,为其临床治疗及研究提供参考及循证医学支持。方法:计算机检索数据库PubMed、EMbase、中国知网(CNKI)、维普数据库(VIP)及万方数据库(WANFANG),以温针灸治疗类风湿关节炎的临床随机对照试验(RCT)为研究对象,检索时间为建库至2018年4月。由两位研究员独立筛选文献,提取文献资料及评估偏倚风险并采用RevMan 5. 3软件对数据进行分析。结果:共纳入21个RCT研究,总样本量为1619例,其中试验组856例,对照组763例。Meta分析结果显示:在有效率方面,21个试验显示温针灸及其联合疗法相对于对照组,组间差异有统计学意义[OR=4. 43,95%CI(3. 28,5. 99),P<0. 00001],且在症状体征如晨僵时间,亚组温针灸对照毫针刺法治疗[WMD=-33. 94,95%CI(-53. 10,-14. 79),P=0. 0005],温针灸联合西药对照西药治疗[WMD=-10. 88,95%CI(-21. 21,-0. 54),P=0. 04]以及双手平均握力,亚组温针灸联合西药对照西药治疗[WMD=1. 91,95%CI(0. 70,3. 12),P=0. 002]均具有统计学差异。但在实验室检查如血沉,亚组温针灸对照毫针刺法治疗[WMD=-6. 06,95%CI(-25. 27,13. 15),P=0. 54]、温针灸联合西药对照西药治疗[WMD=-4. 01,95%CI(-9. 86,1. 84),P=0. 18]; C反应蛋白,亚组温针灸联合西药对照西药治疗[WMD=-1. 54,95%CI(-3. 61,0. 53),P=0. 15];类风湿因子,亚组温针灸对照毫针刺法治疗[WMD=-0. 16,95%CI(-0. 41,0. 08),P=0. 19],温针灸联合西药对照西药治疗[WMD=-0. 11,95%CI(-0. 59,0. 37),P=0. 65],其组间结果均不具有统计学意义。结论:温针灸及其联合疗法治疗类风湿关节炎,相对于单用毫针刺法、中药或西药,可进一步提高以晨僵时间、双手平均握力等症状、体征为主的临床疗效,但对于实验室检查如血沉、C反应蛋白、类风湿因子对照组比较无明显差异。由于现有临床研究存在数量少,质量低等问题,故需要更多高质量,大样本,多中心的临
Objective：To evaluate the effect of warming needle moxibustion combined therapy on rheumatoid arthritis to provide reference and evidence-based medicine support for its clinical treatment and research.Meth- ods：PubMed, EMbase, CNKI, VIP and WANFANG were searched, the clinical randomized controlled trial of warming needle moxibustion on rheumatoid arthritis （RCT） was used as the research object. The retrieval time was from the establishing of the database to April 2018.The two researchers independently screened the litera- ture, extracted the literature data and evaluated the bias risk. The data were analyzed by Rev Man 5.3 software. Results：A total of 1619 cases were included in 21 RCT studies, including 856 cases in the trial group and 763 cases in the control group. The results of recta-analysis showed that, of the effective rate, 21 experiments showedthat the warming needle moxibustion and its combined therapy had statistical significance compared with the control group [ OR = 4, 43,95%CI （ 3.28,5.99）, P〈0. 00001 ] .There were significant differences in the symptoms and signs, such as morning stiffness time ： subgroup of warming needle moxibustion to filiform needle therapy [ WMD = -33.94, 95%CI （ -53. 10, - 14. 79）, P = 0. 000], warming needle moxibustion to western medicine （WMD=-10. 88, 95%CI（ -21.21,-0. 54）, P=0. 04], and the mean grip strength of both hands： subgroup of warming needle moxibustion medicine[ WMD = 1.91,95%CI（ 0. 70,3. 12）, P= 0. 002 ], had statis- tical differences.However, the results were not statistically significant in laboratory tests such as blood deposi- tion：subgroup of warming needle moxibustion compared to filiform needle therapy [ WMD =-6. 06, 95% ci （- 25.27,13.15）, P=0. 54], warming needle moxibustion to western medicine[ WMD=-4. 01,95%CI（ -9. 86, 1.84） ,P=0. 18], C-reactive protein： warming needle moxibustion to western medicine [ WMD=-1. 54, 95% CI （-3.61,0. 53 ）, P = 0. 15 ], Rheumatoid factor： subgroup of warming needle mo
作者
邓路达
卢筱潇
崔瑾
DENG Luda;LU Xiaoxiao;CUI Jin(Guiyang University of Chinese Medicine,Guiyang 550025,Guizhou China;Chengdu University of Traditional Chinese Medicine,Chengdu 610000,Sichuan China)
出处
《贵阳中医学院学报》
2018年第6期82-92,共11页
Journal of Guiyang University of Chinese Medicine
关键词
温针灸
类风湿关节炎
META分析
系统评价
warming needle moxibustion
rheumatoid arthritis
Meta-analysis
system evaluation
