12种针灸相关疗法治疗银屑病网状Meta分析  

Meta Analysis of 12 Acupuncture Related Therapies for Psoriasis

作　　者：陶萍萍 陈秀华[1,2] 吴思平[1,2] 李晓惠 多英[1] TAO Pingping;CHEN Xiuhua;WU Siping;LI Xiaohui;DUO Ying(Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广东省中医院,广东广州510120

出　　处：《云南中医学院学报》2020年第6期51-61,共11页Journal of Yunnan University of Traditional Chinese Medicine

基　　金：广东省科学技术厅-广东省中医药科学院联合科研专项(2012A032500014);广州市科技计划项目(201609010090)。

摘　　要：目的采用网状Meta分析评价针灸相关疗法治疗银屑病的疗效及安全性。方法计算机检索CBM、CNKI、Wanfang、VIP、PubMed、Embase、Cochrane Library 7个数据库,检索时限自建库至2020年10月,对纳入的文献进行筛选、资料提取及偏倚风险评价。采用Stata15.0进行网状Meta分析。结果共纳入27个研究(n=2612),涉及针刺+西医、针刺+放血+西医、火针+西医、艾灸+西医、放血+西医、针刺+火针+放血、针刺+火针、针刺、放血、火针+放血、针刺+放血、火针12种针灸疗法。网状Meta分析以总有效率为结局指标的RCTs 26项,涉及11种针灸疗法,以PASI为结局指标的RCTs 18项,涉及10种针灸疗法。改善银屑病疗效总有效率的SUCRA具体排序为:针刺+放血+西医>针刺+放血>针刺+火针>针刺+火针+放血>放血>针刺+西医>放血+西医>火针+放血>火针+西医>针刺>火针>西医;改善银屑病PASI的SUCRA具体排序为艾灸+西医>针刺+西医>针刺+火针+放血>放血+西医>火针+西医>针刺+火针>火针+放血>针刺>放血>火针>西医。网状Meta结果分析:针刺+放血+西医、针刺+放血、针刺+火针、针刺+火针+放血、放血、针刺+西医、放血+西医、火针+放血、火针+西医、针刺治疗银屑病总有效率优于常规西医治疗。艾灸+西医、针刺+西医、火针+西医、火针+放血治疗改善银屑病PASI优于常规西医。结论单一疗法推荐放血的治疗方案;联合治疗中推荐针刺+放血+西医的治疗方案,但因此次纳入研究较少,受研究质量限制,临床需谨慎施治。Objective To evaluate the efficacy and safety of acupuncture-related therapies for psoriasis through a network Meta-analysis.Methods A total of seven electronic databases including CBM,CNKI,Wanfang,VIP,PubMed,Embase,and the Cochrane Library were searched for psoriasis,from inception to October 2020.The included literature were screened,extracted,and assessed for bias.Documents were analyzed by Stata 15.0 in network Meta-analysis.Results A total of 27 studies(n=2612)were included,which involved 12 kinds of acupuncture and moxibustion therapies:acupuncture+western medicine,acupuncture+bloodletting+western medicine,fire needle+western medicine,moxibustion+western medicine,bloodletting+western medicine,acupuncture+fire needle+bloodletting,acupuncture+fire needle,acupuncture,bloodletting,fire needle+bloodletting,acupuncture+bloodletting and fire needle.In the network meta-analysis,26 RCTs with total effective rate as the outcome index involved 11 kinds of acupuncture therapy,and 18 RCTs with PASI as the outcome index involved 10 kinds of acupuncture therapy.Sorting results of surfaces under the cumulative ranking curves regarding effective rates:acupuncture+bloodletting+western medicine>acupuncture+bloodletting>acupuncture+fire needle>acupuncture+fire needle+bloodletting>bloodletting>acupuncture+western medicine>bloodletting+western medicine>fire needle+bloodletting>fire needle+western medicine>acupuncture>fire needle>western medicine.Sorting results of surfaces under the cumulative ranking curves regarding the change of PASI:moxibustion+western medicine>acupuncture+western medicine>acupuncture+fire needle+bloodletting>bloodletting+western medicine>fire needle+western medicine>acupuncture+fire needle>fire needle+bloodletting>acupuncture>bloodletting>fire needle>western medicine.Network Meta-analysis shows that the ten therapies were better than western medicine,including acupuncture+bloodletting+western medicine,acupuncture+bloodletting,acupuncture+fire needle,acupuncture+fire needle+bloodletting,bloodletting,acupunct

关 键 词：银屑病 针刺 艾灸 火针 放血 随机对照试验(RCTs) 网状Meta分析 

分 类 号：R246.7[医药卫生—针灸推拿学]