针灸治疗高脂血症随机对照临床试验的系统评价  

Effectiveness and Safety of Acupuncture and Moxibustion for Hyperlipidemia: A Systematic Review

作　　者：刘迈兰[1] 张国山[1] 李成文[1] 汪厚莲 呙安林 刘密[1] 常小荣[1] 

机构地区：[1]湖南中医药大学针灸推拿学院,湖南长沙410007

出　　处：《辽宁中医杂志》2015年第11期2065-2070,共6页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金课题资助(81173326);中医药管理局推广项目;博士科研基金项目(9982-1001-014);大学生创新项目(1021-0001-017-065)

摘　　要：目的:系统评价针灸与西药比较治疗高脂血症的疗效和安全性。方法:计算机检索CBM、CNKI、VIP和WanFang Data,检索时限至2014年4月,纳入针灸(针刺、电针、温和灸、氦-氖激光穴位针法)与西药(普伐他汀片、辛伐他汀、非诺贝特、洛伐他汀)比较治疗高脂血症的临床随机对照试验(RCT)。由2位研究人员根据纳入与排除标准独立进行文献筛选、数据提取、质量评价,由第3人进行核对,分歧文献由第3人裁定。采用Rev Man 5.2软件进行Meta分析。结果:共纳入9个RCT,733例患者,Meta分析结果显示:(1)LDL-C降低值,针灸组优于药物组[MD=1.05,95%CI(0.86,1.25),P<0.00001];(2)TC降低值,药物组优于针灸组[MD=-0.31,95%CI(-0.46,-0.15),P<0.0001];(3)TG降低值,针灸组优于药物组[MD=0.62,95%CI(0.45,0.79),P<0.00001];(4)HDL-C升高值,针灸组优于药物组[MD=0.62,95%CI(0.45,0.79),P<0.00001];(5)总有效率,针灸组与药物组对于高脂血症均有效,无明显差异[OR=1.26,95%CI(0.90,1.77),P=0.18]。结论:基于当前临床证据,针灸治疗高脂血症患者的疗效在降低LDL-C和TG水平以及提高HDL-C的水平方面优于药物组。Objective： To systematically assess the effectiveness and safety of acupuncture and moxibustion for the treatment of hyperlipidemia. Methods： Databases including CBM,CNKI,VIP and Wanfang were electronically searched from inception to Apr.2014 for the randomized controlled trials（ RCTs） on acupuncture and moxibustion（ manual acupuncture,electroacupuncture,He-Ne laser acupoint needling method） versus drugs（ pravastatin,simvastatin,lovastatin fenofibrate） for hyperlipidemia. Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data and assessed the methodological quality of the included. The third researcher checked the results and ruled the literature which the two reviewers had different comments on. And then,the Meta- analysis was performed using Rev Man 5. 2 software. Results： In total,9 RCTs and 733 patients were included. The results of Meta- analysis indicated：（ 1） Acupuncture and moxibustion group＇ s effects on decreasing LDL- C was better than that of the drugs group[MD = 1. 05,95% CI（ 0. 86,1. 25）,P 〈0. 00001].（ 2） Drugs group＇s effects on decreasing TC was better than that of the acupuncture and moxibustion group[MD =- 0. 31,95% CI（- 0. 46,- 0. 15）,P 〈0. 0001].（ 3）Acupuncture and moxibustion group＇ s effects on decreasing TG was better than that of the drugs group[MD = 0. 62,95% CI（ 0. 45,0. 79）,P 〈0. 00001].（ 4） Acupuncture and moxibustion group＇s effects on decreasing HDL- C was better than that of the drugs group[MD = 0. 62,95% CI（ 0. 45,0. 79）,P 〈0. 00001].（ 5） Acupuncture and moxibustion and drugs groups were both effective for hyperlipidemia and there was no significant difference between two groups[OR = 1. 26,95% CI（ 0. 90,1. 77）,P =0. 18]. Conclusion： Based on current clinical evidence,for hyperlipidemia,the effectiveness of acupuncture and moxibustion was better than the drugs＇,except the decreasing of TC value. And the safety of acupuncture and moxibustion was be

关 键 词：针灸 药物 高脂血症 系统评价 META分析 随机对照试验 

分 类 号：R246.1[医药卫生—针灸推拿学] R589.2[医药卫生—中医临床基础]