普通针刺对比常规西药治疗儿童抽动障碍的Meta分析  

General Acupuncture Versus Conventional Western Medicine in the Treatment of Tic Disorder in Children: A Meta-Analysis

作　　者：林雁[1] 喻闽凤 黄烁佳 张超虹 邓琳蓉 LIN Yan;YU Min-Feng;HUANG Shuo-Jia;ZHANG Chao-Hong;DENG Lin-Rong(Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Shenzhen Hospital of Chinese Medicine,Shenzhen 518000 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]深圳市中医院,广东深圳518000

出　　处：《广州中医药大学学报》2022年第12期2989-2996,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：深圳市科技创新委员会资助项目(编号:重202206);广东省名中医传承工作室建设项目(编号:粤中医办函[2020]1号)。

摘　　要：【目的】系统评价普通针刺对比常规西药治疗儿童抽动障碍(TD)的临床疗效和安全性。【方法】计算机检索中国期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、美国医学在线(PubMed)、荷兰医学文献数据库(Embase)及Web of Science等各大数据库。收集有关普通针刺和常规西药治疗TD的随机对照试验(RCT)文献,检索时间为各数据库自建库以来至2022年1月14日。采用RevMan 5.4.1软件对纳入文献进行Meta分析。采用Cochrane Handbook 5.1.0提供的偏倚风险评价工具进行文献质量评价。【结果】共纳入14篇文献进行Meta分析,共905例患者。Meta分析结果显示:治疗组总有效率高于对照组,RR=1.29,95%CI(1.19,1.39),Z=6.60,P<0.00001;治疗组耶鲁综合抽动严重程度量表减分率(YGTSS)总评分优于对照组,SMD=-1.68,95%CI(-1.89,-1.36),Z=12.10,P<0.00001。2篇文献报道了不良反应,所报道的针刺组不良反应发生率分别为23.33%和15.00%,西药组则为36.67%和70.00%。【结论】普通针刺相对于常规西药治疗TD可能有更好的疗效和安全性,但由于针刺本身的特性无法实施盲法、西药种类不统一可能对结局造成影响、不良反应报道较少,存在信息偏倚的可能,未来需要更严谨的RCT进一步验证这一结论。Objective To systematically evaluate the clinical efficacy and safety of general acupuncture versus conventional western medicine in the treatment of tic disorders(TD)in children.Methods Computer searches were conducted on major databases such as CNKI,Wanfang,VIP,CBM,PubMed,Embase and Web of Science.The literature on randomized controlled trials(RCTs)of general acupuncture and conventional western medicine for TD was collected and searched from each database since its inception to 14 January 2022.Meta-analysis of the included literature was performed using RevMan 5.4.1 software.The risk of bias assessment tool provided by Cochrane Handbook 5.1.0 was used to evaluate the quality of the literature.Results Meta-analysis of a total of14 papers with 905 patients were included.The results of the Meta-analysis showed that:the total effective rate being RR=1.29,95%CI(1.19,1.39),Z=6.60,P<0.00001;the Yale General Tic Severity Scale(YGTSS)total score SMD=-1.68,95%CI(-1.89,-1.36),Z=12.10,P<0.00001.There were two papers reported adverse reactions,with reported rates of 23.33%and 15.00%in the acupuncture group and 36.67%and 70.00%in the western medicine group,respectively.Conclusion General acupuncture may have superior efficacy and safety relative to conventional western medicine for TD.However,due to the nature of acupuncture itself,it is not possible to perform a blinding method.Meanwhile,the inconsistent types of western medicine may have an impact on outcomes,and the adverse reactions were poorly reported,with the potential for information bias,therefore a more rigorous RCT is needed to further validate this conclusion in the future.

关 键 词：针刺 常规西药 抽动障碍 儿童 随机对照试验 META分析 

分 类 号：R246.9[医药卫生—针灸推拿学]