摘要
目的:系统评价针灸治疗尿毒症皮肤瘙痒的疗效和安全性。方法:计算机检索维普数据库、中国知网、万方数据库、中国生物医学文献数据库、Web of Science和Pub Med数据库建库至2023年12月31日有关针灸治疗尿毒症皮肤瘙痒的随机对照临床试验类文献。对符合标准的文献使用Rev Man 5.4.3软件进行数据分析,并评估其风险偏倚的程度。结果:共纳入16项研究,涉及1 077名受试者。Meta分析结果表明,试验组有效率[OR=0.22,95%CI(0.13,0.38),P<0.000 01]高于对照组,瘙痒症状评分[SMD=-1.65,95%CI(-2.21,-1.09),P<0.000 01]、瘙痒VAS评分[SMD=-1.93,95%CI(-2.90,-0.96),P=0.000 1]、甲状旁腺激素(PTH)水平[SMD=-0.68,95%CI(-1.09,-0.26),P=0.001]、β2微球蛋白水平[SMD=-0.84,95%CI(-1.13,-0.56),P<0.000 01]、组胺水平[SMD=-0.90,95%CI(-1.63,-0.17),P=0.02]均低于对照组,差异均有统计学意义(P<0.05)。两组患者血磷[SMD=-0.20,95%CI(-0.41,0.01),P=0.06]、血钙[SMD=-0.10,95%CI(-0.43,0.23),P=0.54]、肌酐[SMD=-0.12,95%CI(-0.43,0.19),P=0.44]、尿素氮[SMD=-0.13,95%CI(-0.51,0.26),P=0.53]比较,差异均无有统计学意义(P>0.05)。试验组不良反应出现概率低于对照组,且未出现严重不良反应。结论:针灸能缓解尿毒症皮肤瘙痒患者的瘙痒症状,降低瘙痒评分,且无明显的不良反应,但受限于纳入文献的质量和样本量,证据强度尚不足,尚需高质量证据进一步确认。
Objective:To systematically evaluate the efficacy and safety of acupuncture in the treatment of itchy skin in uremia.Methods:A computerized search was conducted for randomized controlled clinical trialtype literature on acupuncture for itchy skin in uremia from VIP database,China Knowledge Network(CNKI),Wanfang database,China Biomedical Literature Database,Web of Science,and Pub Med databases from the establishment of the database to December 31st,2023.The literature that met the criteria was analyzed for data using Rev Man 5.4.3 software and the degree of risk of bias was assessed.Results:A total of 16 studies were included,involving 1077 participants.The meta-analysis showed that the experimental group had a higher effective rate [OR=0.22,95% CI(0.13,0.38),P <0.000 01] than the control group,the itch symptom scores[SMD=-1.65,95% CI(-2.21,-1.09),P<0.000 01],itch VAS score [SMD=-1.93,95% CI(-2.90,-0.96),P=0.000 1],parathyroid hormone(PTH) level [SMD =-0.68,95% CI(-1.09,-0.26),P =0.001],β2-microglobulin level [SMD=-0.84,95% CI(-1.13,-0.56),P<0.000 01],and histamine level [SMD=-0.90,95% CI(-1.63,-0.17),P=0.02] were all lower than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference(P>0.05) between the two groups of patients in terms of blood phosphorus[SMD=-0.20,95% CI(-0.41,0.01),P=0.06],blood calcium [SMD=-0.10,95% CI(-0.43,0.23),P=0.54],creatinine[SMD=-0.12,95% CI(-0.43,0.19),P=0.44],and urea nitrogen [SMD=-0.13,95% CI(-0.51,0.26),P=0.53].The probability of adverse reactions in the experimental group was lower than that in the control group,and no serious adverse reactions occurred.Conclusion:Acupuncture can alleviate the itching symptoms of uremic patients with skin itching,reduce the itching score,and there is no obvious adverse reaction.However,due to the quality and sample size of the included literature,the evidence strength is still insufficient,and high-quality evidence needs to be further confirmed.
作者
王睿
王宇阳
占永立
WANG Rui;WANG Yuyang;ZHAN Yongli(Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China;Guang'anmen Hospital,China Academy of Traditional Chinese Medicine,Beijing 100029,China)
出处
《中医药导报》
2024年第12期181-188,共8页
Guiding Journal of Traditional Chinese Medicine and Pharmacy
基金
国家自然科学基金项目(82204905,82374419)
中央级公益性科研院所基本科研业务费专项基金项目(ZZ16-YQ-014)
中央高水平中医医院临床科研业务费资助(HLCMHPP2023004)。
