针灸治疗肌肉骨骼系统和结缔组织疾病循证等级病谱研究  

Acupuncture for Diseases of the Musculoskeletal System and Connective Tissue Based on Medical Evidence

作　　者：张议元[1,2] 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：《辽宁中医药大学学报》2016年第11期43-50,共8页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家"十一五"科技支撑计划项目(2006BAI12B01)

摘　　要：目的:以循证医学文献质量等级分类标准筛选针灸治疗肌肉骨骼系统和结缔组织病证的临床随机对照文献,分析针灸对照其他各种干预措施的临床证据、证据强度、推荐等级,以获得本系统的循证等级针灸病谱。方法:以《中国生物医学光盘数据库》为检索源,通过人工阅读初步获得肌肉骨骼系统和结缔组织疾病的针灸适宜病症,为进一步研究提供检索病名。在此基础上,以CBM、CNKI、VIP、WF等数据库为检索源,全面收集针灸治疗肌肉骨骼系统和结缔组织疾病的临床随机对照文献,选择符合纳入标准的临床试验研究进行分析,通过建立现代针灸适宜病症临床研究文献数据库(Access)进行整理,获得临床证据。结果:73种肌肉骨骼系统和结缔组织病证。其中A级证据18篇,支持5种病证;B级证据124篇,支持13种病证;C级证据639篇,支持24种病证;D级证据109篇,支持31种病证。循证等级针灸病谱:Ⅰ级病谱3种,Ⅱ级病谱10种,Ⅲ级病谱22种,Ⅳ级病谱7种,Ⅴ级病谱31种。结论:上述73种病证的相应循证等级针灸病谱,仅供临床参考使用。其中有些病证可供纳入的RCT有限,以后还应深入开展大样本、多中心临床对照试验的研究,为针灸临床提供最佳证据,从而有利于提供可靠的临床路径实施依据。Objective：To preliminarily obtain the acupuncture-moxibustion disease spectrum of musculoskeletal system and connective tissue diseases with literature study,and then screen the randomized control trials of those diseases treated by acupuncture-moxibustion on this basis,analyze the clinical therapeutic evidence,evidence strength and recommended levels of acupuncture-moxibustion treatment compared with other interventions,in order to get the overview of the evidence-based acupuncturemoxibustion disease spectrum rank of this system. Methods：Using＂CBM＂as the retrieval source,through manual reading and preliminarily got the acupuncture-moxibustion disease spectrum of musculoskeletal system and connective tissue diseases,and provided retrieval disease names for further study. Based on this,adopted CBM,CNKI,VIP,WF,etc as retrieval source. Throughly collected the randomized control clinical trials of acupuncture-moxibustion treating the musculoskeletal system and connective tissue diseases,selected the trials in accordance with the inclusive criteria for analyzing. Through establishing the database of clinical research literature about the suitable diseases of modern acupuncture-moxibustion,collected and analyzed the trials with Access. Results：In 73 kinds of this system diseases,18 A level of evidences include 5 kinds of this system diseases,while 124 B level of evidences including 13 kinds,639 C level of evidences including 24 kinds and 109 D level including 31 kinds. The evidence-based acupuncture-moxibustion disease spectrum includes 3 kinds of I grade disease spectrum,10 kinds of II grade,22 kinds of Ⅲ grade,7 kinds of Ⅳ grade and 31 kinds of Ⅴgrade disease spectrum. Conclusion：The above 73 different diseases of the corresponding evidence-based acupuncture grade disease,only reference to clinical spectrum use. Some diseases of RCT limited,should also carry out in-depth after large sample,multicenter controlled clinical trial of research,to provide the best evidence,and thus to facilitate reliable

关 键 词：针灸 肌肉骨骼系统和结缔组织疾病 临床随机对照试验 临床证据 循证等级针灸病谱 

分 类 号：R685[医药卫生—骨科学]