热敏灸治疗颈椎病随机对照试验的Meta分析  

Meta-analysis of Randomized Controlled Trials in the Treatment of Heat-sensitive Moxibustion for Cervicalspondylosis

作　　者：吴丝丝[1] 杜春燕[1] 刘红霞[1] 苏春香[1] 尚雅彬 胡阅 李嘉琪 WU Si-si;DU Chun-yan;LIU Hong-xia;SU Chun-xiang;SHANG Ya-bin;HU Yue;LI Jia-qi(School of Nursing, Beijing Univel：sity of Chinese Medicine, Beijing 100102, China)

机构地区：[1]北京中医药大学护理学院,北京100102

出　　处：《中医药导报》2018年第7期89-95,共7页Guiding Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：目的:评价热敏灸治疗颈椎病的临床疗效和安全性。方法:电子检索CNKI、VIP、Wanfang、CBM、Pubmed、Embase和Cochrane图书馆,收集热敏灸治疗颈椎病的随机对照试验,并辅以手工检索,按照CochraneHandbook5.0和改良Jadad量表对纳入研究进行质量评鉴,统计学分析采用Revman5.3软件。结果:共纳入16篇文献,合计1424例患者。各研究的基线资料具有可比性。Meta分析显示:(1)治愈率:热敏灸VS传统灸,RR=2.05,95%CI[1.57,2.67](P<0.01);热敏灸VS针刺,RR=1.51,95%CI[1.10,2.07](P<0.05),差异有统计学意义。(2)有效率:热敏灸VS传统灸,RR=1.23,95%CI[1.15,1.32](P<0.01);热敏灸+针刺VS针刺,RR=1.17,95%CI[1.08,1.26](P<0.01),差异有统计学意义;敏感性分析显示合并结果较稳定。仅有2项试验交代治疗过程中无不良反应,其余试验均未描述不良反应情况。倒漏斗图分析显示纳入文献可能存在发表偏倚。结论:热敏灸治疗颈椎病较安全有效,但因纳入文献数量有限且质量较低,结论尚不确定,需要更多大样本、多中心的高质量随机对照试验来进一步验证。Objective： To systematically review the clinical efficacy and safety of heat-sensitive moxibustion （HSM） therapy for eerviealspondylosis. Methods： All randomized clinical trials（RCTs） on the clinical efficacy and safety of HSM therapy for cervicalspondylosis were searched in CNKI, VIP, Wanfang, CBM, Pubmed, Embase database and Cochrane library by electronic and manual retrieval. The methodological quality of included studies was assessed according to the Cochrane Handbook 5.0 and the improved Jadad scale. Then the Meta-analysis was performed using RevMan 5.3 software. Results： A total of 16 literatures were included, containing with a to- tal of 1424 patients. The baseline data of included studies were comparable. TheMeta-analysis showed that： （1） Cure rate： thermal moxibustion V$ traditional moxibustion, RR=2.05, 95%CI（1.57,2.67） （P〈0.01）. Thermal moxibustion VS acupuncture, RR=I.51, 95% CI （1.10, 2.07） （P〈0.05）, the differences were statistically significant. （2） Effective rate： thermal moxibustion VS traditional moxibustion, RR= 1.23, 95%CI（1.15, 1.32） （P〈0.01）. Thermal moxibustion plus acupuncture VS acupuncture, RR=I.17, 95% C1（1.08,1.26） （P〈0.01）, the differences were statistically significant. The sensitivity analysis showed the merged results were relatively stable. Only two literatures mentioned there were no adverse reactions during the test, and the other tests did not describe the adverse reactions. Funnel plot analysis showed a publication bias in the literature. Conclusion： Thermal moxibustion therapy for eerviealspondylosis is relatively effective and safe, but the conclusion is not clear due to the limited literatures and the suboptimal methodological quality of I/CTs. So more high-quality and muhi-eenter RCTs with large sample are needed to confirm the clinical efficacy and safety of heat-sensitive moxibustiontherapy.

关 键 词：热敏灸 颈椎病 META分析 

分 类 号：R255.6[医药卫生—中医内科学]