针灸与柳氮磺胺吡啶治疗强直性脊柱炎有效性的网状Meta分析  

Efficacy of Acupuncture and Sulfasalazine for Ankylosing Spondylitis: A Network Meta-analysis

作　　者：张笑[1] 罗晓舟[1] 曹秋雨 邓赣 唐纯志[1] ZHANG Xiao;LUO Xiaozhou;CAO Qiuyu;DENG Gan;TANG Chunzhi(Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China)

机构地区：[1]广州中医药大学

出　　处：《中华中医药学刊》2018年第10期2321-2324,I0004,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)项目(2012CB518500)

摘　　要：目的：采用基于贝叶斯理论的随机效应模型MCMC法网状Meta分析评价针灸治疗强直性脊柱炎的临床疗效。方法 ：计算机检索检索Google Scholar、Pub Med、Cochrane Library、CNKI、VIP、CBM、万方数据库从建刊至2017年10月发表的关于针灸治疗强直性脊柱炎的随机对照试验/半随机对照试验（RCT/CCT）文献,由2名研究者按照Cochrane手册5. 1. 0标准对每项纳入的研究进行质量和偏倚风险评估。应用Stata 14. 0绘制网状结构图,应用Ge MTC 0. 14. 3进行数据统计。结果：最终25项研究符合纳入标准,累计病例2208例,共涉及柳氮磺胺吡啶、针、灸、蜂针、针＋灸、针＋灸＋罐、针＋罐、针＋灸＋蜂针、灸＋蜂针等9种干预措施。网状Meta分析结果显示：柳氮磺胺吡啶与针、柳氮磺胺吡啶与灸、柳氮磺胺吡啶与针＋灸、柳氮磺胺吡啶与针＋灸＋罐、柳氮磺胺吡啶与针＋罐、柳氮磺胺吡啶与针＋灸＋蜂针、柳氮磺胺吡啶与灸＋蜂针、针与针＋灸、针与针＋灸＋罐、灸与针＋灸、灸与针＋灸＋罐、蜂针与针＋灸＋罐之间总有效率差异有统计学意义。按疗效最佳的可能性排序,从高到低依次为：针＋灸＋罐、针＋灸＋蜂、灸＋蜂针、针＋灸、针＋罐、灸、针、蜂针、柳氮磺胺吡啶。结论：现有的研究证据显示,针灸综合疗法优于单一疗法和柳氮磺胺吡啶,针＋灸＋罐、针＋灸＋蜂、灸＋蜂针为治疗本病的最佳疗法可能性大,但确切结论仍需大量高质量RCT予以证实。Objective： To evaluate the clinical efficacy of acupuncture and moxibustion in the treatment of ankylosing spondylitis by using the random effects model based on Bayesian theory. Methods： A computer-controlled search of Google Scholar,Pub Med,Cochrane Library,CNKI,VIP,CBM and Wanfang database were published from the publication to October 2017. Randomized controlled trials/acombined randomized controlled trials on acupuncture for ankylosing spondylitis（ RCT/CCT） literature were assessed the risk of quality and bias by two researchers in accordance with the Cochrane Handbook 5. 1. 0. Stata 14. 0 was used to draw the network structure diagram and Ge MTC 0. 14. 3 to do the statistics. Results： The final 25 studies met the inclusion criteria,a total of 2208 cases,involving sulfasalazine,acupuncture,moxibustion,bee acupuncture,acupuncture ＋ moxibustion,acupuncture ＋ moxibustion ＋ cupping,moxibustion ＋bee needle and other 9 kinds of interventions. The results of network Meta-analysis showed that the combination of sulfasalazine and acupuncture,sulfasalazine and moxibustion,sulfasalazine and acupuncture ＋ moxibustion,sulfasalazine and acupuncture ＋ moxibustion ＋ canister,sulfasalazine and acupuncture ＋ canister,sulfasalazine and acupuncture ＋ bee needle,sulfasalazine and moxibustion ＋ bee needle,needle and needle ＋ moxibustion,acupuncture and acupuncture ＋moxibustion ＋ cupping,moxibustion and acupuncture ＋ moxibustion,moxibustion and acupuncture ＋ moxibustion ＋ cupping. The total effective rate between bee needle and acupuncture ＋ moxibustion ＋ cupping was statistically significant.According to the best possible curative effect,the order from high to low is acupuncture ＋ moxibustion ＋ cupping,acupuncture ＋ moxibustion ＋ bee,moxibustion ＋ bee acupuncture,acupuncture ＋ moxibustion,acupuncture ＋ cupping,moxibustion,acupuncture,bee acupuncture,Sulfapyridine. Conclusion： The existing research evidence shows that acupuncture and moxibustion is superior to monothera

关 键 词：针灸 柳氮磺胺吡啶 强直性脊柱炎 有效性 网状Meta分析 

分 类 号：R245.3[医药卫生—针灸推拿学] R593.23[医药卫生—中医临床基础]