腹针治疗颈椎病临床随机对照研究的系统评价  

A Systematic Review of Randomized Controlled Clinical Trials of Abdominal Acupuncture Treatment of Cervical Spondylosis

作　　者：王妍文[1] 符文彬[2] 欧爱华[2] 樊凌[1] 黄叶飞[1] 

机构地区：[1]广州中医药大学第二临床医学院,广州510405 [2]广东省中医院,广州510120

出　　处：《针刺研究》2011年第2期137-144,共8页Acupuncture Research

基　　金：国家"十一五"科技支撑计划(No.2006BAI12B04);广东省科技计划项目(No.2009B030801287)

摘　　要：目的:对腹针治疗颈椎病临床随机对照研究进行疗效与方法学质量评价,了解腹针治疗颈椎病的现况、临床疗效的真实程度及可应用性。方法:电子检索PubMed数据库、中国期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)及万方中华医学会期刊数据库,在排除重复、无具体诊断标准及非随机等对照研究后,筛选出符合纳入标准的随机对照研究,用Jadad评分对这些文献进行质量评价,疗效评价采用ReviewManage 4.2.7软件。结果:8项研究,共909例患者纳入本次分析。8项研究均以有效率作为主要结局指标,2项研究同时采用麦吉尔疼痛量表进行疗效评价。对同质性较强的研究进行Meta分析,显示目测类比定级法评分(VAS评分)中腹针组优于对照组(P<0.05);治疗后总有效率评价、疼痛评定指数评分与现时疼痛强度评分均无足够证据证明腹针组优于对照组。结论:与其它针刺疗法、牵引疗法相比较,腹针治疗颈椎病的疗效并无优势。这可能与纳入研究的样本量较少、文献质量偏低有一定关系。重视和加强腹针治疗颈椎病随机对照试验的大样本、高质量研究,探索出可行的针灸设盲方法是研究者急待解决的问题。Objective To assess the effect and methodological quality of clinically randomized controlled studies on abdominal acupuncture therapy for cervical spondylosis and to make out its current situation, validity and applicability. Methods Using the PubMed, CNKI （China Academic Journals Full-text Database）, VIP （VIP Chinese Science and Technology Periodicals Database） and Wanfang Digital Periodicals Electronic Database covering the period of 1989-2009, we did a literature search on the original articles of abdominal acupuncture treatment of cervical spondylosis and selected those accorded with the standards of randomized controlled studies. Animal studies, surveys, and news articles, and those duplicated, being absent in diagnostic criteria and non-randomized controlled trials were excluded. The papers＇ quality was analyzed by using the Jadad quality assessment scoring system and the therapeutic effect evaluated by using Review Manage 4.2.7 software. Results A total of 8 papers containing 909 cervical spondylosis patients and written in Chinese were included. These 8 studies used the effective rate as the primary outcome, 2 of them used the McGill Pain Questionnaire scales at the same time. Meta-analysis showed that the abdominal acupuncture group was better than the control group in visual analogue scale score （P〈0.05）. No significant differences were found between abdominal acupuncture and routine acupuncture [ OR = 3.29,95 % CI （0. 13,82.99 ）], EA [OR = 2.09,95% CI （0.36,11.95）] and traction therapy [DR=6.06.95% C1（3.01,12. 18）] in the total effective rate, pain rating index score [WMD = -2.24,95% C1（-5.29,0.81）]and the present pain intensity score[WMD=-0.84,95% C1（-2. 13,0.44）]. Conclusion At the present, there has been no sufficient evidence to ensure that in the treatment of cervical spondylosis, the abdominal acupuncture therapy is superior to routine acupuncture. EA and traction therapy. Attention should be paid to the randomized controlled study of larger samples and qualif

关 键 词：腹针 颈椎病 随机对照临床试验 系统评价 

分 类 号：R245.329[医药卫生—针灸推拿学]