摘要
背景慢性萎缩性胃炎是一种临床常见的癌前病变,容易反复发作,严重影响患者生活质量。目前西医治疗慢性萎缩性胃炎效果有限,而针灸治疗慢性萎缩性胃炎具有良好的效果,但具体哪种针灸疗法治疗效果更好,仍未有定论。目的运用网状Meta分析方法评价不同针灸疗法治疗慢性萎缩性胃炎对临床疗效、胃镜疗效、病理疗效的差异性。方法计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Embase、WebofScience数据库建库至2023-04-30针灸治疗慢性萎缩性胃炎的随机对照试验,按照纳排标准进行筛选。基于ROB2偏倚风险评估工具进行文献质量评估,使用RStudio软件进行网状Meta分析,使用Stata软件绘制漏斗图进行发表偏倚风险评估。结果纳入文献26篇,涉及10种干预措施,样本量2068例。网状Meta分析结果显示,在临床疗效上,西药+穴位注射、穴位埋线、西药+针刺、温针灸、针刺干预措施均优于常规西药治疗(P<0.05),累积排序概率图下面积(SUCRA)排序结果为西药+穴位注射(0.86)>穴位埋线(0.80)>西药+针刺(0.67)>温针灸(0.59)>西药+火龙灸(0.58)>针刺(0.48)>西药+隔姜灸(0.40)>雷火灸(0.31)>西药+电针(0.24)>常规西药(0.06);在胃镜疗效上,穴位埋线、温针灸、西药+针刺、针刺、西药+穴位注射均优于常规西药治疗(P<0.05),SUCRA排序结果显示:穴位埋线(0.80)>温针灸(0.72)>西药+针刺(0.58)>针刺(0.47)>西药+穴位注射(0.41)>常规西药(0.01);在病理疗效上,穴位埋线、温针灸优于常规西药治疗(P<0.05),SUCRA排序结果显示:穴位埋线(0.79)>西药+针刺(0.59)>温针灸(0.53)>针刺(0.52)>西药+穴位注射(0.51)>常规西药(0.06)。结论临床症状明显患者可选用西药联合穴位注射缓解症状,而临床症状不明显的患者则优先选用穴位埋线,穴位埋线不仅能改善临床症状,在改善胃镜疗效及病理疗效上较其他
Background Chronic atrophic gastritis is a common clinical precancerous lesion,which is prone to recurrent attacks and seriously affects the quality of life of patients.At present,Western medicine has limited effect in the treatment of chronic atrophic gastritis,while acupuncture has good results in the treatment of chronic atrophic gastritis,but which acupuncture therapy is the best still inconclusive.Objective To compare the clinical efficacy among different acupuncture and moxibustion therapies on chronic atrophic gastritis by network meta-analysis.Methods The articals of randomized controlled trials for chronic atrophic gastritis treated with acupuncture and moxibustion therapies were searched from CNKI,Wanfang Data,VIP,CBM,PubMed,Embase and Web of Science until April 30,2023 according to the inclusion exclusion criteria.Literature quality assessment was based on ROB2 bias assessment tool,network meta-analysis was performed using RStudio software,and funnel plotting was used Stata software for publication bias risk assessment.Results 26 articles involving 10 interventions with a sample size of 2068 cases were included.The results of network meta-analysis showed that in clinical efficacy,there were five acupuncture therapies were superior to conventional western medicines,including western medicine combined with acupoint injection,catgut embedment in acupoint therapy,western medicine combined with acupuncture,needle warming therapy and acupuncture(P<0.05).The SUCRA ranking result was western medicine combined with acupoint injection(0.86)>catgut embedment in acupoint therapy(0.80)>western medicine combined with acupuncture(0.67)>needle warming therapy and acupuncture(0.59)>western medicine combined with fire dragon moxibustion(0.58)>acupuncture(0.48)>western medicine combined with ginger separated moxibustion(0.40)>thunder-fire moxibustion(0.31)>western medicine combined with electroacupuncture(0.24)>conventional western medicine(0.06).In improving the efficacy of gastroscopy,five acupuncture therapies were su
作者
王婷
王海燕
富文俊
WANG Ting;WANG Haiyan;FU Wenjun(School of Basic Medical Sciences,Guangzhou University of Chinese Medicine,Guangzhou 510006,China)
出处
《中国全科医学》
CAS
北大核心
2024年第23期2913-2920,2930,共9页
Chinese General Practice
基金
广州市科技计划项目(202201011643)。
关键词
慢性萎缩性胃炎
针灸疗法
疗效
网状Meta分析
Chronic atrophic gastritis
Acupuncture moxibustion therapy
Efficacy
Network meta-analysis
