提升针灸研究质量:现状、问题、思考和展望  

Improving acupuncture research: progress, guidance, and future directions

作　　者：岗卫娟[1] 费宇彤[2] 刘建平[2] 赵宏 陆丽明[4] 许能贵[4] 刘保延[5] 张誉清[6] 景向红[1] GANG Wei-juan;FEI Yu-tong;LIU Jian-ping;ZHAO Hong;LU Li-ming;XU Neng-gui;LIU Bao-yan;ZHANG Yu-qing;JING Xiang-hong(Institute of Acupuncture and Moxibustion,China Academy of Chinese Medica Sciences,Beijing 100700,China;Centre for Evidence-Based Chinese Medicine,Beijing University of CM;Department of Acupuncture and Moxibustion,Shenzhen Luohu District Hospital of TCM;South China Research Center for Acupuncture and Moxibustion,Guangzhou University of CM;China Academy of Chinese Medica Sciences;Department of Health Research Methods,Evidence,and Impact,McMaster University,Hamilton Canada)

机构地区：[1]中国中医科学院针灸研究所,北京100700 [2]北京中医药大学循证医学中心 [3]深圳市罗湖区中医院针灸科 [4]广州中医药大学华南针灸研究中心 [5]中国中医科学院 [6]麦克马斯特大学健康研究方法、证据与影响学系,加拿大汉密尔顿

出　　处：《中国针灸》2023年第1期3-7,共5页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金资助项目:81973968、82274660;中国中医药循证医学中心资助项目:2020YJSZX-1。

摘　　要：对《英国医学杂志》(BMJ)发表的针灸专辑“如何提升针灸证据质量”系列文章进行解读。研究显示针灸随机对照临床试验(RCT)报告质量较低,多因素Meta回归分析未能证实多数通常认为的针灸效应影响因素;分析了针灸RCT面临的方法学挑战,形成如何设计高质量针灸RCT方法学共识,系统评价证据数量巨大但未得到充分应用,大量西医临床实践指南推荐针灸疗法但推荐意见实用性有待提高。针对该专辑中提到的针灸临床研究存在的问题,结合分析针灸临床研究目的与研究视角、研究类型以及研究证据与临床决策的关系,提出了针灸临床研究的五阶段研究模式。This paper makes an interpretation of the collection Acupuncture: how to improve the evidence base published by BMJ & BMJ Open. Studies show that the quality of randomized controlled trial(RCT) of acupuncture is low, and multivariable Meta-regression analysis fails to confirm most factors commonly believed to influence the effect of acupuncture.The methodological challenges in design and conduct of RCT in acupuncture were analyzed, and a consensus on how to design high-quality acupuncture RCT was developed. The number of acupuncture systematic reviews was huge but the evidence was underused in clinical practice and health policy, and a large number of western clinical practice guidelines recommended acupuncture therapy, but the usefulness of recommendations needed to be improved. In view of the problems in clinical research on acupuncture mentioned in this collection, combined with the analysis of the purpose of clinical research on acupuncture, perspectives, study types, as well as the relationship between evidence and clinical decision-making, a five-stage study paradigm of clinical research on acupuncture is proposed.

关 键 词：针灸 随机对照试验 临床实践指南 系统评价 研究模式 

分 类 号：R245[医药卫生—针灸推拿学]