中医外治法治疗偏头痛疗效Meta分析  

Meta analysis of the curative effect of TCM external treatment on migraine

作　　者：王鲁扬 刘源香[2] WANG Luyang;LIU Yuanxiang(The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250355 [2]山东中医药大学附属医院,山东济南250013

出　　处：《陕西中医》2023年第11期1640-1645,共6页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助面上项目(82174491);国家重点研发计划项目(2022YFC3500403)。

摘　　要：目的:系统评价临床常用中医外治法治疗偏头痛的效果。方法:以临床常用的针刺、拔罐、推拿、耳穴压豆、刺血等中医外治法及“偏头痛”为关键词,检索CNKI数据库、CBM数据库、VIP数据库、万方数据库、Pub Med数据库、Web of Science数据库中偏头痛的随机对照试验并进行分析。提取相关文献原始数据,比较中医外治与单用西药治疗偏头痛的疗效,利用漏斗图对文献发表偏倚进行评估。结果:检索到1474篇相关文献,最终纳入17篇。运用固定效应模型对总效应值进行合并分析,漏斗图显示左右基本对称,提示发表偏倚较小。Meta分析表明,中医外治法治疗偏头痛的疗效高于单纯西药(I2<50%、P<0.01)。在VAS量表中纳入的7篇文献进行针刺与刺血的亚组分析,刺血疗法的效应量(-0.43,Z=2.86,P<0.05),针刺疗法的效应量(-1.38,Z=8.69,P<0.05),意味着针刺与刺血疗法可显著缓解偏头痛,且针刺疗法效果优于刺血疗法;偏头痛大脑前动脉(ACA)血流速度的分析中纳入3篇文献(I2<50%,P<0.01),中医外治法比单纯西药治疗能更大程度地降低ACA血流速度,缓解头痛。结论:针刺、推拿、拔罐、耳穴压豆、刺血治疗偏头痛的有效性优于单纯西药,中西医结合治疗能提高偏头痛防治效果。Objective:To systematically evaluate the intervention effect of external therapy of traditional Chinese medicine in the treatment of migraine.Methods:The key words were acupuncture,cupping,massage,auricular point pressing beans,pricking blood and migraine.Search CNKI database,CBM database,VIP database,Wanfang database,Pub Med database,randomized controlled trial of migraine in the Web of Science database to analysis.The original data of related literature were extracted,and the curative effects of external treatment of TCM and western medicine alone on migraine were compared.Evaluated publication bias using funnel plots.Results:1474 related articles were retrieved and 17 were included.The fixed effect model was used to analyze total effect values.The funnel plot showed that the left and right were basically symmetrical,suggesting the publication bias was small.Meta analysis showed that the efficacy of TCM external treatment for migraine was higher than that of western medicine alone(I 2<50%,P<0.01).The subgroup analysis of acupuncture and pricking blood were carried out in 7 articles included in the headache index scale VAS(-0.43,Z=2.86,P<0.05),the dose of acupuncture was(-1.38,Z=8.69,P<0.05),meaning that acupuncture and pricking blood therapy can significantly relieve migraine,Meta-analysis of blood flow velocity of anterior cerebral artery(ACA)in migraine included 3 articles(I 2<50%,P<0.01),it is concluded that external treatment of TCM can reduce ACA blood flow velocity more than simple western medicine to relieve headaches.Conclusion:Acupuncture,massage,cupping,auricular point pressing beans,pricking blood were more effective than simple western medicine in the treatment of migraine.Integrated traditional Chinese and western medicine can improve effect of prevention and treatment of migraine.

关 键 词：偏头痛 针刺疗法 推拿 拔罐 耳穴压豆 刺血疗法 

分 类 号：R747.2[医药卫生—神经病学与精神病学]