刺络放血治疗痛风性关节炎疗效及安全性Meta分析  

Efficacy and Safety of Pricking Blood Therapy on Gouty Arthritis :a Meta Analysis

作　　者：刘维[1] 赵文甲 吴沅皞[1] 

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

出　　处：《辽宁中医药大学学报》2017年第12期5-9,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：教育部高等学校博士学科点专项科研基金项目(20132120110003);天津市高等学校科技发展基金计划项目(20120220);天津中医药大学第一附属医院“拓新工程”基金项目(院201309)

摘　　要：目的 :系统评价刺络放血治疗痛风的临床疗效及安全性。方法 :收集刺络放血治疗痛风临床随机对照试验。通过计算机检索Pub Med、EMbase、Cochrane图书馆、中国知网、维普数据和万方数据,查找有关应用刺络放血与西药治疗痛风的随机对照试验(Randomized Controlled Trial,RCT),检索时限均从建库至2016年12月,使用Revman 5.3软件进行Meta分析。结果 :共纳入9个研究,合计738例患者。Meta分析结果显示刺络放血在总有效率[RR=1.15,95%CI(1.10,1.21)]、降低尿酸(uric acid,UC)[SMD=-1.54,95%CI(-2.25,-0.82)]、疼痛视觉模拟评分(Visual Analogue Scale/Score,VAS)[SMD=-0.77,95%CI(-1.16,0.38)]、血沉(erythrocyte sedimentation rate,ESR)[SMD=-0.77,95%CI(-1.16,0.38)]以及超敏C反应蛋白(high sensitivity C reactive protein,hs-CRP)[SMD=-0.83,95%CI(-1.56,-0.09)]等方面均优于常规西药治疗,在不良反应发生率方面,刺络放血与西药相比较少,差异有统计学意义[RR=0.06,95%CI(0.01,0.45)],表明刺络放血安全性更好。结论 :本Meta分析结果显示,应用刺络放血治疗痛风优于常规西药治疗,为痛风临床治疗提供了一个新的选择,但是由于纳入研究样本量较小、质量偏低,上述结论仍需大规模临床试验加以验证。Objective ：To evaluate the efficiency and safety of pricking blood for treating gout.Methods ：The databases such as Pub Med,EMbase,Cochrane library retrieval,China CNKI,Wan Fang Data and VIP data were searched by computer to collect randomized controlled trials（RCTs）for gout by pricking blood from the date of their establishment to October 2016.To find the studies about application of bloodletting puncture therapy and Western medicine for treating gout.Meta-analyses were conducted by using Rev Man 5.3.Results ：A total of 9 studies involving a total of 738 patients were included.Meta analysis results showed that the pricking blood therapy was superior in the following aspects with significant differences ：the total efficiency rate[RR=1.15,95%CI（1.10,1.21）],uric acid（UC）[SMD=-1.54,95%CI（-2.25,-0.82）],visual analogue scale/score（VAS）[SMD=-0.77,95%CI（-1.16,0.38）],erythrocyte sedimentation rate（ESR）[SMD=-0.77,95%CI（-1.16,0.38）]and high sensitivity C reactive protein（hs-CRP）[SMD=-0.83,95%CI（-1.56,-0.09）].In the incidence of adverse reactions,compared with Western medicine,pricking blood was statistically significant[RR=0.06,95%CI（0.01,0.45）],which showed better and safety of pricking blood.Conclusion ：The results of Meta analysis showed that the application of pricking blood therapy in treating gout was better than conventional Western medicine treatment,and provided a new choice for the treatment of gout.But due to the small sample size and the low quality,this conclusion still needs large-scale clinical trials to verify.

关 键 词：痛风 刺络放血 系统评价 META分析 

分 类 号：R684.3[医药卫生—骨科学]