针灸联合多种方法治疗骨质疏松的网状Meta分析  

Acupuncture combined with other therapies for osteoporosis: a network meta-analysis

作　　者：岑卓灏 陈洁娜 黄嘉华 石础硕 周驰[1] 温俊茂 凌敏[1] Cen Zhuohao;Chen Jiena;Huang Jiahua;Shi Chushuo;Zhou Chi;Wen Junmao;Ling Min(Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China)

机构地区：[1]广州中医药大学

出　　处：《中国组织工程研究》2020年第2期320-328,共9页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81373655);广东省自然科学基金(2015A030310203),项目负责人:周驰;广东省高水平大学建设项目(A1-AFD018171Z11057),项目负责人:周驰~~

摘　　要：背景:针灸及其联合其他疗法与标准西医疗法之间比较治疗骨质疏松有效性的研究结论存在争议,现有的原始研究和Meta分析多为单一针灸治疗、针灸联合西药治疗与标准西医疗法间的比较,缺乏针灸联合其他疗法之间的直接比较,使人们难以对针灸疗效有较清晰、全面的认识。目的:采用网状Meta分析技术,比较针灸联合其他疗法治疗骨质疏松疗效的差异。方法:在CNKI、维普、万方、SinoMed、PubMed、Cochrane Library数据库上进行检索,纳入不同针灸疗法对比治疗骨质疏松的临床随机对照试验(RCT)。根据相关纳入与排除标准对文献进行筛选后提取相关资料,并对纳入文献进行质量评价。运用Stata 14.0软件进行文献数据分析及作图。结果与结论:最终纳入34篇随机对照试验,共涉及7种干预措施,包括:单一针灸治疗,单一西药治疗,单一中药治疗,针灸+西药联合治疗,针灸+中药联合治疗,中药+西药治疗,针灸+中药+西药联合治疗。①在治疗有效率上,针灸+中药的疗效最佳,且针灸+中药、针灸+西药以及针灸+中药+西药,均显著比中药+西药治疗的有效率高(P<0.05);②在增加患者骨密度方面,针灸+中药、针灸+西药以及针灸+中药+西药,均优于单一中药或西药组(P<0.05);③在缓解患者疼痛方面,与单一西药治疗相比,针灸+西药治疗能缓解患者的疼痛(P<0.05),但其余治疗方式之间,并无明显的差异(P>0.05)。在纳入的研究中,有极少数患者出现针刺后穴位瘀血现象,但均未出现晕针或未报道,也未发现其他毒副作用。提示:针灸联合其他疗法,可以提高有效率、增加骨密度、缓解患者疼痛。BACKGROUND:Comparative study results between the treatment efficiency of acupuncture plus other combination therapy and western medicine therapy in the treatment of knee osteoarthritis remain controversial.Currently,meta-analysis studies mainly focus on comparison of the efficacy between single acupuncture treatment,acupuncture plus western medicine combination therapy and western medicine,but there is a lack of investigation on acupuncture combined with other therapies.It is difficult to fully understand the efficacy of acupuncture.OBJECTIVE:To compare the effects of acupuncture therapy,conventional western medicine and Chinese medicine on osteoporosis treatment by network meta-analysis.METHODS:A search was performed on the CNKI,VIP,WanFang,SinoMed,PubMed,and Cochrane Library databases to include the randomized controlled trials of different acupuncture treatments for osteoporosis.Relevant data were extracted after screening the literature according to relevant inclusion and exclusion criteria,and the quality of the included literature was evaluated.Literature data analysis and mapping were performed using Stata 14.0 software.RESULTS AND CONCLUSION:Thirty-four randomized controlled trials were included,involving seven interventions,such as single acupuncture treatment,single western medicine treatment,single Chinese medicine treatment,acupuncture plus western medicine combination therapy,acupuncture plus Chinese medicine combination therapy,Chinese medicine+western medicine treatment,acupuncture+Chinese medicine+western medicine combined treatment.(1)In the treatment efficiency,acupuncture combined with traditional Chinese medicine is the best in the treatment of primary osteoporosis,and acupuncture combined with traditional Chinese medicine,acupuncture combined with western medicine and acupuncture combined with traditional Chinese medicine western medicine were significantly better than traditional Chinese medicine combined with western medicine(P<0.05).(2)In increasing the bone mineral density of patients,acu

关 键 词：针灸 中药 骨质疏松 治疗有效率 骨密度 疼痛积分 网状Meta分析 联合治疗 

分 类 号：R459.9[医药卫生—治疗学] R245[医药卫生—临床医学]