针灸治疗椎-基底动脉供血不足临床随机对照试验文献质量评价  

Quality Evaluation of Randomized Controlled Trails Papers on Acupuncture and Moxibustion for Vertebrobasilar Insufficiency

作　　者：杨丽红[1] 黎波[2] 熊俊[2] 杜元灏[2] 

机构地区：[1]天津中医药大学,天津300193 [2]天津中医药大学第一附属医院,天津300193

出　　处：《中国中医药信息杂志》2009年第10期104-107,共4页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家"十一五"科技支撑计划(2006BAI12B01)

摘　　要：目的评价国内针灸治疗椎-基底动脉供血不足的临床试验质量。方法收集针灸治疗椎-基底动脉供血不足临床随机对照试验(RCT),并按国际Cochrane协作网Cochrane手册随机对照研究标准及临床流行病学评价方法对文献进行分析评价。结果16篇文献符合纳入标准,87.5%的文献存在随机方法描述不清、未描述随机隐藏及盲法使用率、无样本量计算、无意向治疗分析等问题。其中明确诊断标准的占62.5%,正确使用随机方法的占12.5%,明确疗效评价标准的占62.5%,31.22%的文献未提及组间可比性。结论尽管针灸已被广泛运用于椎-基底动脉供血不足的防治,但因其RCT数量较少、质量水平仍然较低,尚无法为临床提供可信性高的证据,严重阻碍了针灸临床疗效的验证和发展。建议有条件的研究机构进行针灸治疗椎-基底动脉供血不足的前瞻性、多中心、随机对照试验,探索出疗效确切、可行性强的针灸方法,为进一步开展针灸治疗椎-基底动脉供血不足的系统评价提供基础条件。Objective To evaluate the quality of clinical trials about acupuncture and moxibustion treatment of vertebrobasilar insufficiency in China. Methods Literature of clinical trials of acupuncture was collected and analyzed, evaluated by the randomized controlled test criteria and the clinical assessing method in Cochrane handbook of international Cochrane cooperation net. Results Sixteen literatures were brought in. 87.5% of the included literature had no clear description of random methods, and no allocation concealment, use of blind methods, sample size calculation, intention-to-treat analysis. Among them, 62.5% had explicit diagnosis criteria, 12.5% with correct randomizing method, 62.5% with explicit evaluation criteria, however, 31.22% with no words refernng to the comparability among the groups. Conclusions Though acupuncture and moxibustion have been widely applied in prevention and treatment of vertebrobasilar insufficiency , it can not provide evidences of higher reliability for clinical treatment due to less clinical randomized controlled tests and lower quality, which severely hinder testing and verifying of clinical therapeutic effects of acupuncture and moxibustion. It is proposed that multiple central and randomized controUed test should be made, so as to search for feasible acupuncture and moxibustion methods with definite therapeutic effect for vertebrobasilar insufficiency, and provide basis for further systematical evaluation.

关 键 词：椎-基底动脉供血不足 随机对照试验 针灸疗法 质量评价 

分 类 号：R2-05[医药卫生—中医学]