艾灸百会联合针刺治疗颈性眩晕的Meta分析与试验序贯分析  

Moxibustion at Baihui combined with acupuncture for cervical vertigo:a Meta-analysis and trial sequential analysis

作　　者：麦威 卜献忠[2] 苗芙蕊 芮靖琳[3] 黄丽琳[2] 赵晓君 范郁山 MAI Wei;BU Xian-zhong;MIAO Fu-rui;RUI Jing-lin;HUANG Li-lin;ZHAO Xiao-jun;FAN Yu-shan(Department of Traditional Chinese Medicine,Guangxi Medical University Cancer Hospital,Nanning 530021,China;Guangxi University of Chinese Medicine,Nanning 53000l;College of Acupuncture and Massage,Guangxi University of Chinese Medicine,Nanning 530001)

机构地区：[1]广西医科大学附属肿瘤医院中医科,南宁530021 [2]广西中医药大学,南宁530001 [3]广西中医药大学针灸推拿学院,南宁530001

出　　处：《针刺研究》2023年第1期95-101,共7页Acupuncture Research

基　　金：广西壮族自治区中医药管理局中医药人才队伍建设专项范郁山广西名中医传承工作室项目(No.2021022-001-12);广西自然科学基金项目(No.2018GXNSFAA281066);广西中医药大学研究生教育创新计划项目(No.YCBSZ2020003)。

摘　　要：目的:系统评价艾灸百会联合针刺治疗颈性眩晕(CV)的疗效及安全性。方法:计算机检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Cochrane Library、Embase数据库,检索日期为从建库至2021年9月15日,搜集以艾灸百会联合针刺治疗CV的随机对照试验,利用Cochrane偏倚风险评估工具评价纳入文献的质量。采用RevMan5.3、Stata12.0、TSA0.9.5.10 Beta软件进行Meta分析和试验序贯分析(TSA)。结果:共纳入17篇文献,包括1232例患者。Meta分析结果显示:试验组(艾灸百会联合针刺治疗)在临床总有效率[RR=1.17,95%CI(1.12,1.22),P<0.0001]、愈显率[RR=1.28,95%CI(1.20,1.36),P<0.0001],改善眩晕症状与功能评分[WMD=2.88,95%CI(1.87,3.89),P<0.0001]方面均优于对照组(单纯针刺或电针治疗)。TSA结果显示,临床总有效率累计纳入的研究穿过了传统界值和TSA界值,进一步肯定了艾灸百会联合针刺治疗CV的临床疗效。结论:艾灸百会联合针刺治疗CV的临床疗效明确。Objective To evaluate the efficacy and safety of moxibustion at Baihui(CV20)combined with acupuncture in treatment of cervical vertigo.Methods From the databases,such as CNKI,VIP,WanFang,CBM,PubMed,Cochrane Library and Embase,the studies of randomized controlled trials(RCTs)on moxibustion at CV20 combined with acupuncture for cervical vertigo were searched from inception to September 15th,2021.The Cochrane risk of bias assessment tool was utilized to evaluate the quality of the included literature.Using RevMan5.3,Stata12.0 and TSA0.9.5.010 Beta software,the Meta-analysis and trial sequential analysis(TSA)were performed.Results Seventeen RCTs with 1232 patients were included.Meta-analysis showed that in the trial group(moxibustion at CV20 combined with acupuncture),the total effective rate(RR=1.17,95%CI[1.12,1.22],P<0.0001),the curative and remarkably-effective rate(RR=1.28,95%CI[1.20,1.36],P<0.0001)and the score of cervical vertigo(WMD=2.88,95%CI[1.87,3.89],P<0.0001)were all better when compared with the control group(simple acupuncture or electroacupuncture group).The results of trial sequential analysis indicated that for the cumulative Z-score of each RCT,the Z-curve crossed the conventional test boundary and TSA boundary,which further confirmed the clinical efficacy of moxibustion at CV20 combined with acupuncture on cervical vertigo.Conclusion The clinical efficacy of moxibustion at CV20 combined with acupuncture is determined in treatment of cervical vertigo.

关 键 词：艾灸 针刺 百会 颈性眩晕 随机对照试验 Meta分析 试验序贯分析 

分 类 号：R245.8[医药卫生—针灸推拿学]