巨刺法治疗急性期周围性面瘫临床疗效的Meta分析  

Meta-analysis of the Clinical Efficacy of Contralateral Needling in Treating Acute-stage Peripheral Facial Paralysis

作　　者：吴碧雯 姚问 张江松[1] 林咸明[1] WU Bi-wen;YAO Wen;ZHANG Jiang-song;LIN Xian-ming(The 3rd Clinical Medical College of Zhejiang Chinese Medical University,Hangzhou 310053,China)

机构地区：[1]浙江中医药大学第三临床医学院,杭州310053

出　　处：《上海针灸杂志》2018年第3期338-347,共10页Shanghai Journal of Acupuncture and Moxibustion

摘　　要：目的采用系统评价的方法比较巨刺法与患侧针刺法治疗急性期周围性面瘫的临床疗效。方法通过计算机和人工方法检索关于巨刺法治疗急性期周围性面瘫的临床研究类型的文献,检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、Pubmed、Web of Science、EMbase、The Cochrane Library,收集建库以来至2017年3月期间发表的关于巨刺法治疗急性期周围性面瘫的临床随机对照试验,并运用Cochrane系统评价的方法,使用Rev Men5.3软件进行Meta分析。结果检索出相关文献276篇,最终纳入11篇文献,共获761例急性期周围性面瘫患者,其中巨刺组394例,患侧针刺组367例。Meta分析结果显示巨刺法治疗急性期周围性面瘫的有效率及治愈率均优于患侧针刺法[有效率RR=1.06,95%CI为(1.01,1.11),Z=2.32,P=0.02;治愈率RR=1.53,95%CI为(1.31,1.78),Z=5.42,P<0.01];其次,巨刺法比患侧针刺法更能改善面神经功能,对改善面部活动程度更具有优势[HB值WMD=0.26,95%CI(0.04,0.48),Z=2.34,P=0.02;FDIP值WMD=3.77,95%CI(1.53,6.01),Z=3.30,P<0.01]。结论巨刺法治疗急性期周围性面瘫值得在临床上应用。但由于本次系统评价纳入文献数量较少且质量不够理想,因此仍需高质量、大样本、多中心的随机临床研究加以证实。Objective To compare the clinical efficacy between contralateral needling and homolateral(the affected side)needling in treating acute-stage peripheral facial paralysis by using systematic evaluation.Method By computer and manual retrieval,literatures about clinical trials on contralateral needling in treating acute-stage peripheral facial paralysis published before March of2017were collected from China National Knowledge Infrastructure(CNKI),WanFang database,Vip database,China Biology Medicine disc(CBMdisc),Pubmed,Web of Science,EMbase and The Cochrane Library.By adopting the Cochrane systematic evaluation,the collected data underwent meta-analysis by using RevMen5.3software.Result A total of276articles were retrieved and11articles were finally recruited,including761patients with acute-stage facial paralysis,394cases treated by contralateral needling and367by homolateral needling.The meta-analysis showed that contralateral needling produced more significant effective rate and recovery rate than homolateral needling[effective rate:RR=1.06,95%CI(1.01,1.11),Z=2.32,P=0.02;recovery rate:RR=1.53,95%CI(1.31,1.78),Z=5.42,P<0.01].Moreover,contralateral needling produced a better effect in improving facial nerve function,showing an advantage in ameliorating facial movement[HB:WMD=0.26,95%CI(0.04,0.48),Z=2.34,P=0.02;FDIP:WMD=3.77,95%CI(1.53,6.01),Z=3.30,P<0.01].Conclusion Contralateral needling is worth applying in treating acute-stage peripheral facial paralysis.However,due to the small amount and unsatisfactory quality of the recruited literatures in this systematic evaluation,multiple-centered randomized trials with high quality and large sample size are expected for further verification.

关 键 词：针刺疗法 巨刺 面神经麻痹 周围性面瘫 急性期 META分析 

分 类 号：R246.6[医药卫生—针灸推拿学]