针刺疗法治疗慢性阻塞性肺疾病系统评价的方法学质量及证据质量评价  

Acupuncture for Chronic Obstructive Pulmonary Disease:An Overview of Systematic Reviews of Methodological Quality and Evidence Quality Evaluation

作　　者：田昊 徐桂兴 梁繁荣[1] Tian Hao;Xu Guixing;Liang Fanrong(School of Acupuncture-moxibustion and Tuina,Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province,Chengdu 610075,China)

机构地区：[1]成都中医药大学针灸推拿学院/四川省针灸临床医学研究中心,成都610075

出　　处：《世界科学技术-中医药现代化》2021年第12期4753-4763,共11页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委员会重大项目(82074556):基于外泌体调控研究冠心病心绞痛模型大鼠特异性经穴敏化发生的分子机制,负责人:梁繁荣。

摘　　要：目的针对针刺疗法治疗慢性阻塞性肺疾病(COPD)系统评价(Systematic Review,SR)进行再评价研究,以期为临床医师及研究者提供更科学的决策支持。方法检索针刺及其相关疗法(灸法、敷贴、毫针疗法等)系统评价的文献,筛选文献后提取资料,采用AMSTAR 2量表和GRADE系统工具进行评估。结果共纳入13篇文献,67次结局指标;AMSTAR 2工具评价结果:高质量研究5篇(38.46%),中等质量研究6篇(46.15%),低质量研究2篇(15.38%);GRADE评价工具中,16.42%为中等可信度,53.73%的结局指标为低等可信度,26.87%的结局指标为极低可信度。结论系统评价的结局指标应用GRADE方法进行证据分级显示,针刺治疗COPD的疗效是确切的,但针刺疗法治疗慢性阻塞性肺疾病相关研究质量等级较低,针对此情况,期望开展证据强度、质量、级别高的系统评价,作为高级别证据来指导临床。Objective To reevaluate the systematic review(SR)of acupuncture in the treatment of chronic obstructive pulmonary disease(COPD),in order to provide more scientific decision support for clinicians and researchers.Methods The literatures of systematic evaluation of acupuncture and its related therapy(moxibustion,application,needle therapy,etc.)were retrieved.After screening the literatures,the data were extracted and evaluated by using AMSTAR 2 scale and GRADE system tools.Results A total of 13 literatures and 67 outcome indicators were included.AMSTAR 2 tool evaluation showed 5 high quality studies(38.46%),6 medium quality studies(46.15%),and 2 low quality studies(15.38%);In the GRADE evaluation tool,16.42%of the outcome indicators were medium reliability,53.73%of the outcome indicators were low reliability,and 26.87%of the outcome indicators were extremely low reliability.Conclusion The GRADE method was used to GRADE the outcome indicators of the systematic evaluation,and it showed that the efficacy of acupuncture in treating COPD was definite.However,the quality level of research on acupuncture therapy in the treatment of chronic obstructive pulmonary disease is low.In view of this situation,it is urgent to carry out systematic evaluation with high quality and high evidence intensity,so as to guide clinical practice with high level evidence.

关 键 词：慢性阻塞性肺疾病 COPD AMSTAR2 GRADE等级 

分 类 号：R245.3[医药卫生—针灸推拿学]