推拿干预颈动脉粥样硬化动物模型安全性的系统评价和Meta分析  

Safety of Massage in Animal Models of Carotid Atherosclerosis:A Systematic Review and Meta-analysis

作　　者：袁钰 蒋涛[2] 陈辉 YUAN Yu;JIANG Tao;CHEN Hui(Anhui University of Chinese Medicine,Anhui Hefei 230012,China;The Second Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230061,China)

机构地区：[1]安徽中医药大学,安徽合肥230012 [2]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《安徽中医药大学学报》2023年第4期49-55,共7页Journal of Anhui University of Chinese Medicine

基　　金：安徽中医药大学科研基金项目(2021efylc05);安徽省名中医及基层名中医工作室建设项目(中发展〔2020〕10号);“十四五”省级中医优势特色专科项目(皖中医药服务秘〔2021〕71号)。

摘　　要：目的系统评价推拿干预颈动脉粥样硬化动物模型的风险及安全性。方法检索中国知网、万方、维普、中国生物医学文献数据库以及PubMed、Cochrane Library、Web of Science自建库以来至2022年9月30日收录的所有相关文献。2名研究者独立进行文献检索、数据提取、质量评价,采用软件Review Manager 5.4及Stata 12.0进行Meta分析。结果最终纳入12篇文献,共计兔183只,猴24只。Meta分析结果显示:推拿对血流动力学指标、血管最大载荷值、拉曼光谱脂质特征峰值以及血清脂蛋白相关磷脂酶A2的影响无统计学意义,但会增加血管的最大应力[SMD=0.63,95%CI(0.14,1.12),P=0.01]、弹性模量[SMD=0.94,95%CI(0.49,1.40),P<0.00001]、巨噬细胞平均光密度[MD=2.39,95%CI(1.84,2.94),P<0.00001]及平均微血管密度[MD=10.46,95%CI(2.50,18.42),P=0.01]、血清hs-CRP水平[MD=1.00,95%CI(0.14,1.86),P=0.02],降低血管最大应变[SMD=-0.56,95%CI(-0.99,-0.12),P=0.01]、斑块内胶原纤维含量[MD=-20.05,95%CI(-37.37,-2.73),P=0.02]。但根据敏感性分析,最大载荷值的结果需谨慎对待。结论推拿不会降低颈动脉血流速度,也不会增加血管外周阻力和斑块内脂质核心含量,但可能会使血管弹性以及胶原纤维比例降低,斑块内巨噬细胞和新生血管增多。受纳入文献数量以及质量的限制,上述结论还需要更多高质量的研究进一步验证。Objective To systematically evaluate the risk and safety of massage in animal models of carotid atherosclerosis.Methods We searched Chinese National Knowledge Infrastructure,WanFang Data,VIP,Chinese Biomedical Literature Database,PubMed,the Cochrane Library,and Web of Science for relevant literature from database establishment to September 30th,2022.Literature search,data extraction,and quality evaluation were performed by two researchers independently.Review Manager 5.4 and Stata 12.0 were used for meta-analysis.Results A total of 12 articles were included,involving 183 rabbits and 24 monkeys.Meta-analysis showed that massage had no significant effects on hemodynamic indices,ultimate load,the characteristic peaks of lipids in Raman spectra,and serum lipoprotein-associated phospholipase A2.However,massage significantly increased ultimate stress([standardized mean difference(SMD)=0.63,95%confidence interval(CI):0.14-1.12,P=0.01],elastic modulus(SMD=0.94,95%CI:0.49-1.40,P<0.00001),the mean optical density of macrophages MD=2.39,95%CI:1.84—2.94,P<0.00001),mean microvessel density(MD=10.46,95%CI:2.50—18.42,P=0.01),and high-sensitivity C-reactive protein(MD=1.00,95%CI:0.14-1.86,P=0.02),and significantly decreased ultimate strain(SMD=-0.56,95%CI:-0.99 to-0.12,P=0.01)and collagen fiber content in plaques(MD=-20.05,95%CI:-37.37 to-2.73,P=0.02).However,according to the sensitivity analysis,the results of ultimate load should be treated with caution.Conclusion Massage did not decrease blood flow velocity in the carotid artery or increase its peripheral resistance and lipid core content within plaques.However,massage might decrease vascular elasticity and the proportion of collagen fibers,and increase the number of macrophages and new vessels in plagues.Limited by the quantity and quality of included literature,the conclusions need to be further verified by more high-quality research.

关 键 词：颈动脉粥样硬化 推拿 系统评价 META分析 动物模型 

分 类 号：R543.4[医药卫生—心血管疾病]