网状Meta分析6种常见针灸疗法治疗原发性痛经的疗效与安全性  

Network Meta-analysis on Curative Effect and Safety of Six Common Acupuncture and Moxibustion Therapies on Primary Dysmenorrhe

作　　者：龚小珍[1] 黄颜怡 何广莲 陈思依 马晴 谢阳春[1] GONG Xiaozhen;HUANG Yanyi;HE Guanglian;CHEN Siyi;MA Qing;XIE Yangchun(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine(Guangdong Provincial Hospital of Chinese Medicine),Guangzhou Guangdong 510120,China;Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510006,China)

机构地区：[1]广州中医药大学第二附属医院(广东省中医院),广东广州510120 [2]广州中医药大学,广东广州510006

出　　处：《新中医》2023年第14期133-140,共8页New Chinese Medicine

基　　金：广东省中医药局科研面上项目(20191166)。

摘　　要：目的:基于贝叶斯网状Meta分析评价6种针灸疗法治疗原发性痛经(PD)的临床疗效与安全性。方法:计算机检索PubMed、Web of science等数据库,搜集6种常见针灸疗法(针刺、针灸、艾灸、温针灸、电针及穴位埋线)治疗PD的随机对照试验研究文献,检索时限为2000年1月1日-2020年9月30日。由2位研究者独立筛选文献、提取数据和评价纳入研究的偏倚风险。采用R软件进行数据分析,以Stata16.0软件绘制网状证据图。结果:共纳入98项随机对照试验研究,总计7 410例PD患者,涉及8种干预措施。所有结局指标均显示随机效应模型整体拟合度较好,可以在一致性模型下进行网状Meta分析。在有效率方面,针刺、艾灸、针灸、温针灸、电针、穴位埋线均优于空白或安慰剂、非甾体类抗炎药,针灸、温针灸均优于针刺及艾灸,有效率排序第一为温针灸。在疼痛缓解方面,针灸的效果优于针刺及艾灸,除艾灸与电针外,其余干预措施缓解疼痛的效果均优于非甾体类抗炎药,缓解疼痛效果排序第一为针灸。在安全性方面,各干预措施之间比较,差异无统计学意义,均表现出良好的安全性。结论:6种针灸疗法治疗PD的临床疗效均优于非甾体类抗炎药,针灸与温针灸可成为临床治疗PD的首选疗法。Objective:To evaluate the clinical effect of 6 acupuncture and moxibustion therapies on primary dysmenorrhea(PD)and their safety based on Bayesian Meta-analysis.Methods:Using computers to search databases,including PubMed and Web of science,the research literature on randomized controlled trials of six common acupuncture therapies(needling,acupuncture and moxibustion,moxibustion,warming-needle moxibustion,electroacupuncture and acupoint catgut embedment)for PD were collected from 1 st January,2000 to 30 th September,2020.Two investigators independently screened the literature,extracted data and evaluated the risk of bias in the included studies.R software was used for data analysis and the network chart was made with Stata 16.0 software.Results:A total of 98 studies on randomized controlled trial involving 7410 patients with PD and 8 intervention measures.All outcome indicators suggested that the overall goodness-of-fit of random effect model was good and network Meta-analysis can be done under the consistency model.In terms of effective rate,single needling,moxibustion,acupuncture and moxibustion,warming-needle moxibustion,electroacupuncture and acupoint catgut embedment were better than blank control or placebo and non-steroidal anti-inflammatory drugs,and acupuncture and moxibustion,and warming-needle moxibustion were better than single needling and single moxibustion,with warming-needle moxibustion coming first.As for pain relief,acupuncture was superior to single acupuncture and single moxibustion,and all intervention measures except for moxibustion and electroacupuncture were better than non-steroidal anti-inflammatory drugs,with acupuncture ranking first.There was no significant difference being found in the comparison of safety between the intervention measures,and they all showed good safety.Conclusion:The clinical effects of the six acupuncture and moxibustion therapies for PD are superior to those of non-steroidal anti-inflammatory drugs,acupuncture and moxibustion,and warming-needle moxibustion can of

关 键 词：原发性痛经 针灸疗法 疗效 安全性 网状Meta分析 

分 类 号：R246.3[医药卫生—针灸推拿学] R271.113[医药卫生—中医临床基础]