电针治疗带状疱疹后遗神经痛临床疗效及安全性的Meta分析  

Meta-analysis for Efficacy and Safety of Electroacupuncture in Treating Postherpetic Neuralgia

作　　者：刘盈君[1] 张全爱[1] 吴媛媛[1] 石焱[2] 方剑乔[1] 韩德雄[1] LIU Ying-Jun;ZHANG Quan-Ai;WU Yuan-Yuan;SHI Yan;FANG Jian-Qiao;HAN De-Xiong(The Third Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine,Hangzhou 310012 Zhejiang,China;Hangzhou First People’s Hospital,Hangzhou 310006 Zhejiang,China)

机构地区：[1]浙江中医药大学附属第三医院,浙江杭州310012 [2]杭州市第一人民医院,浙江杭州310006

出　　处：《广州中医药大学学报》2020年第12期2472-2480,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家中医药创新骨干人才项目(编号:zyycy201901-01);“十三五”浙江省中医药(针灸脑病学)重点学科建设项目(编号:2017-XK-A18);浙江中医药大学国家自然科学基金预研专项(编号:2018ZG17);浙江省实验动物科技计划项目(编号:2018C37083);浙江省中医药科技计划项目(编号:2019ZB057)。

摘　　要：【目的】系统评价电针对带状疱疹后遗神经痛(PHN)的有效性和安全性。【方法】计算机检索中国知网期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库(Wanfang)、中国生物医学数据库(CBM)、PubMed、Web of Science(WOS)和The Cochrane Library数据库。查找电针治疗PHN的随机对照研究试验,筛选并提取资料,采用Cochrane偏倚风险工具对纳入文献进行风险评估。应用RevMan 5.3软件进行Meta分析。【结果】共纳入10篇文献,共1009例受试者。Meta分析结果提示,与对照组方法相比,电针能够提升治疗组的总有效率[OR=3.78,95%CI(2.49,5.74),P<0.00001];相反,电针相比于对照组方法能够降低治疗后的视觉模拟评分(VAS)[MD=-1.62,95%CI(-2.31,-0.93),P<0.0001]、复发率[OR=0.19,95%CI(0.06,0.60),P=0.005]、平均每日疼痛评分(ADPS)[MD=-1.50,95%CI(-1.58,-1.42),P<0.00001]、热痛敏[MD=-1.40,95%CI(-1.46,-1.34),P<0.00001]、机械痛敏[MD=-1.60,95%CI(-1.66,-1.54),P<0.00001]、自发性刺痛[MD=-1.00,95%CI(-1.10,-0.90),P<0.00001]、疼痛6点行为评分法(BRS-6)[MD=-0.60,95%CI(-1.17,-0.03),P=0.04]。【结论】电针治疗PHN的总有效率要优于对照组方法,且能够有效地降低治疗组的VAS、复发率、ADPS、热痛敏、机械痛敏、自发性刺痛和BRS-6,但鉴于纳入本研究的文献数量较少、质量不高,电针治疗带状疱疹后遗神经痛的临床疗效及安全性仍有待更多大样本、多中心、高质量的研究加以验证。Objective To systematically evaluate the efficacy and safety of electroacupuncture for the treatment of postherpetic neuralgia(PHN).Methods We used computer to search from databases of CNKI,VIP,Wanfang Data,CBM,PubMed,Web of Science and the Cochrane Library for randomized controlled trials on electroacupuncture treatment for PHN to screen out and extract data.And then Cochrane risk of bias assessment tool was used to assess the risk of included literatures,RevMan 5.3 software was applied for Meta-analysis.Results Ten literatures,involving a total of 1009 subjects,were included.Meta-analysis results suggested that compared with the control group therapy,electroacupuncture improved the overall efficiency[OR=3.78,95%CI(2.49,5.74),P<0.00001],and reduced the Visual Analogue Scale(VAS)scores[MD=-1.62,95%CI(-2.31,-0.93),P<0.0001],recurrence rate[OR=0.19,95%CI(0.06,0.06),P=0.005],average daily pain score(ADPS)[MD=-1.50,95%CI(-1.58,-1.42),P<0.00001],thermal allodynia[MD=-1.40,95%CI(-1.46,-1.34),P<0.00001],mechanical allodynia[MD=-1.60,95%CI(-1.60,-1.54),P<0.00001],spontaneous lancinating pain[MD=-1.00,95%CI(-1.10,-0.90),P<0.00001],and 6-point behavioral rating scale(BRS-6)[MD=-0.60,95%CI(-1.17,-0.03),P=0.04]after treatment.Conclusion Electroacupuncture is effective for treatment of PHN,being superior to the control group therapy,can reduced the VAS scores,recurrence rate,ADPS,thermal allodynia,mechanical allodynia,spontaneous lancinating pain,and BRS-6 scores,however,due to small size and low quality of literatures,more big size,multiple centers and high quality of clinical studies on electroacupuncture treatment for PHN needs to be further verified.

关 键 词：电针 带状疱疹后遗神经痛 随机对照 临床疗效 安全性 META分析 

分 类 号：R246.9[医药卫生—针灸推拿学]