针刺治疗抽动障碍的系统评价再评价  

Systematic Review Re-evaluation of Acupuncture Treatment of Tic Disorder

作　　者：李彩云 张喜莲[1] 吴钰仪 田雨灵 张盈[1] 王贺昱 LI Caiyun;ZHANG Xilian;WU Yuyi;TIAN Yuling;ZHANG Ying;WANG Heyu(The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center of traditional Chinese Medicine,Tianjin China 300381)

机构地区：[1]天津中医药大学第一附属医院/国家中医针灸临床医学研究中心,天津300381

出　　处：《中医学报》2023年第11期2478-2486,共9页Acta Chinese Medicine

基　　金：国家自然科学基金面上项目(82174434);天津市卫生计生行业高层次人才选拔培养工程“津门医学人才项目”{津人才[2017]18号};第五批全国中医临床优秀人才研修项目{国中医药办人教函[2021]271号}。

摘　　要：目的:对针刺治疗抽动障碍(tic disorders,TD)的系统评价(SR)/Meta分析进行再评价。方法:计算机检索中国知网(CNKI)、万方(Wanfang Data)、维普(VIP)、中国生物医学文献数据库(CBM)、PubMed、EMbase、The Cochrane library等中英文数据库,搜索针刺治疗TD的SR/Meta分析,时限为建库至2022年10月6日,由2名研究者独立进行文献筛选及数据提取,并应用PRISMA声明、AMSTAR2量表、GRADE系统分别评价其报道质量、方法学质量及证据质量。结果:共纳入9篇SR/Meta分析,PRISMA声明评价结果显示7篇得分为21~27分,提示报告相对完整;2篇得分为15~21分,提示报告存在一定缺陷。AMSTAR2评价结果显示1篇为中级质量,1篇为低级质量,7篇为极低级质量;GRADE系统评价结果显示49个结局指标中,低级证据23项,极低级证据26项,降级因素为局限性、不一致性、不精确性及发表偏倚。结论:针刺治疗抽动障碍临床疗效肯定,但仅有低质量的证据支持,日后应加强原始研究的方法学设计,开展高质量、大样本的研究。Objective:To re-evaluate the systematic review(SR)/Meta analysis of acupuncture treatment of tic disorder(SR).Methods:Chinese and English databases such as CNKI,Wanfang Data,VIP,CBM,PubMed,EMbase and the Cochranelibrary were searched for SR/Meta analysis of acupuncture treatment TD.The time limit was from the establishment of the database to October 6,2022.Literature screening and data extraction were carried out independently by two researchers.PRISMA statement,AMSTAR2 scale and GRADE system were used to evaluate the quality of report,methodology and evidence.Results:A total of 9 SR/Meta analyses were included.The evaluation results of PRISMA statement showed that 7 articles scored 210.27 points,indicating that the report was relatively complete,and 2 articles scored 150.21 points,indicating that there were some defects in the report.The results of AMSTAR2 evaluation suggested that 1 article was of intermediate quality,1 article was of low quality,and 8 articles were of very low quality,and the results of GRADE system evaluation showed that among the 49 outcome indexes,there were 23 items of low-level evidence and 26 items of very low-level evidence,and the degradation factors were limitation,inconsistency,inaccuracy and publication bias.Conclusion:Acupuncture is effective in the treatment of tic disorder,but it is only supported by low-quality evidence.the methodological design of the original study should be strengthened and high-quality and large-sample research should be carried out in the future.

关 键 词：抽动障碍 针刺 系统评价 质量评价 方法学质量 证据质量 报道质量 

分 类 号：R245.3[医药卫生—针灸推拿学]