揿针治疗变应性鼻炎临床疗效的Meta分析  

Meta-analysis of clinical intradermal acupuncture efficacy for treatment of allergic rhinitis

作　　者：翟睿 李园 于敬龙[1] 陈溪 郑酉友 刘兆兰[2] 王俊宏[1] ZHAI Rui;LI Yuan;YU Jinglong;CHEN Xi;ZHENG Youyou;LIU Zhaolan;WANG Junhong(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Center for Evidence-based Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学循证医学中心,北京100029

出　　处：《山东大学耳鼻喉眼学报》2023年第3期35-45,共11页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的采用Meta分析的方法,系统评价揿针治疗变应性鼻炎的临床疗效及安全性。方法计算机检索PubMed、The Cochrane Library、Web of Science、中国生物医学文献数据库、维普、中国知网和万方数据库,收集揿针治疗变应性鼻炎的随机对照试验,检索时限为建库至2022年10月1日。由两位研究人员对文献进行独立筛选、数据提取、偏倚风险评估及Meta分析。结果本研究共纳入29项临床试验,包括2342例患者。与单纯阳性对照相比,揿针联合治疗可以提高临床总有效率[RR=1.24,95%CI(1.16,1.33),P<0.001]、降低症状及体征量化评分[MD=-0.67,95%CI(-1.12,-0.22),P=0.003]、使鼻部症状视觉模拟评分下降[MD=-0.62,95%CI(-0.97,-0.28),P<0.001]、减少复发人数[RR=0.58,95%CI(0.41,0.82),P=0.002]、降低鼻阻力[MD=-0.13,95%CI(-0.21,-0.05),P=0.001]、使鼻结膜炎生存质量评分下降[MD=-4.17,95%CI(-6.06,-2.29),P<0.001];揿针与抗组胺药相比,治疗后临床总有效率[RR=1.01,95%CI(0.92,1.11),P=0.78]、鼻结膜炎生存质量评分[MD=0.43,95%CI(-1.78,2.65),P=0.70]差异无统计学意义。未见由揿针治疗后发生的严重不良反应。结论揿针治疗变应性鼻炎有较好的疗效和安全性。受限于试验设计及纳入原始文献的数量及质量,Meta分析结果仍需进一步验证,未来相关研究应使用正确的方法学及严格的试验设计方案以期能提供更有力的循证医学支持并为临床诊疗指南的制定提供高质量证据。Objective To systematically evaluate the clinical efficacy and safety of intradermal acupuncture in the treatment of allergic rhinitis using Meta-analysis.Methods PubMed,The Cochrane Library,Web of Science,SinoMed,VIP,CNKI,and Wanfang databases were searched for randomized controlled trials which used intradermal acupuncture to treat allergic rhinitis from database inception to October 1,2022.Two researchers conducted independent screening,data extraction,bias risk assessment,and meta-analysis of the literature.Results This study included 29 clinical trials and 2342 patients.Compared with the positive control group,the intradermal acupuncture combined therapy group showed improvements in clinical total effective rate[RR=1.24,95%CI(1.16,1.33),P<0.001],quantitative scores of symptoms and signs[MD=-0.67,95%CI(-1.12,-0.22),P=0.003],visual analogue score of nasal symptoms[MD=-0.62,95%CI(-0.97,-0.28),P<0.001],number of recurrences[RR=0.58,95%CI(0.41,0.82),P=0.002],nasal resistance[MD=-0.13,95%CI(-0.21,-0.05),P=0.001],and quality of life score for nasal conjunctivitis[MD=-4.17,95%CI(-6.06,-2.29),P<0.001].Compared with antihistamines,there was no significant difference in clinical total effective rate[RR=1.01,95%CI(0.92,1.11),P=0.78]and quality of life score for nasal conjunctivitis[MD=0.43,95%CI(-1.78,2.65),P=0.70]after treatment.No serious adverse reactions occurred after intradermal acupuncture treatment.Conclusion Using intradermal acupuncture to treat allergic rhinitis shows good curative effects and safety,and can reduce recurrence rates and nasal resistance,as well as improve quality of life.Due to the limits of our experimental design and issues related to the quantity and quality of original literature,the results of our meta-analysis still need to be further verified.In the future,relevant research should utilize other methodologies and strict experimental designs to provide more powerful,high-quality evidence-based data for the development of clinical diagnosis and treatment guidelines.

关 键 词：揿针 变应性鼻炎 随机对照试验 META分析 

分 类 号：R276.1[医药卫生—中医五官科学]