穴位贴敷疗法治疗慢性胃炎的临床疗效观察及Meta分析  

Clinical observation and meta-analysis of the therapeutic effect of acupoint application therapy on chronic gastritis

作　　者：董津乐 白光[2] 王婧 司甲茹 刘方晓 DONG Jin-le;BAI Guang;WANG Jing(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China;不详)

机构地区：[1]辽宁中医药大学,沈阳110847 [2]辽宁中医药大学附属医院脾胃科,沈阳110031

出　　处：《中国处方药》2023年第11期37-42,共6页Journal of China Prescription Drug

基　　金：第三届国医大师传承工作室及全国名中医传承工作室建设项目(辽宁中医函字[2018]76号);中医消化领域优势病种(慢性萎缩性胃炎)专科专病循证能力提升专项(2019XZZX-XH008);辽宁省辽派中医学术经验和技能活态传承项目(2021-01);重大疾病治疗重点专科建设(国家中医优势专科)项目(2022-304)。

摘　　要：目的 通过数据分析,系统评价中医穴位贴敷疗法在治疗慢性胃炎(CG)方面的有效性及安全性。方法 计算机检索中国知网(CNKI)、万方数据(Wanfang)、维普期刊论文检测系统(VIP)、中国生物医学数据库(CBM)、PubMed、Web of Science、荷兰医学文献数据库(Embase)、国际循证医学图书馆(Cochrane Library)数据库中有关穴位贴敷疗法治疗慢性胃炎的随机对照研究(RCTs),语言限制为中、英文。由2名研究员对纳入文献提取相关数据并采用Review Manager 5.4软件进行Meta分析。结果 本研究共纳入17项随机对照研究,共计2 375例患者。Meta分析结果显示,穴位贴敷联合常规药物治疗CG的临床总有效率比单纯药物治疗更高[RR=1.21,95%CI(1.12,1.31),P <0.000 01],更有效地降低腹胀症状评分[MD=-0.35,95%CI(-0.63,-0.08),P=0.01],能够更有效地降低白细胞介素-6(IL-6)水平[MD=-50.85,95%CI(-98.39,-3.32),P=0.04],不良反应发生率更低[RR=0.33,95%CI(0.14,0.80),P=0.01],随访期复发率也更低[OR=0.10,95%CI(0.01,0.86),P=0.04];常规西医药物疗法联用穴位贴敷配合艾灸后可明显提高临床总有效率[RR=1.21,95%CI(1.12,1.31),P <0.000 01],降低随访期疾病复发率[OR=0.17,95%CI(0.05,0.60),P=0.006],降低胃脘痛症状评分[MD=-1.32,95%CI(-1.48,-1.16),P <0.000 01],不良反应发生率更低[RR=0.41,95%CI(0.16,1.03),P=0.06]。结论 通过中医穴位贴敷疗法用于治疗慢性胃炎(CG)具有较高的安全性和有效性,临床上可将其和其他疗法联用以辅助提高疗效。Objective To systematic evaluate the efficacy and safety of acupoint application therapy for the treatment of chronic gastritis(CG)through data analysis.Methods Search CNKI,Wanfang,VIP,CBM,PubMed,Web of Science,Embase,Cochrane Library for randomized controlled studies(RCTs)of acupoint application in the treatment of chronic gastritis.The language was limited to Chinese and English.Two researchers extracted relevant data from the included literatures and performed Meta-analysis using Review Manager 5.4 software.Results A total of 17 RCTs were included in this study,involving 2375 patients.The results of Meta-analysis showed that clinical total effective rate of acupoint sticking combined conventional drugs was higher than pure drug therapy in the treatment of CG[RR=1.21,95%CI(1.12,1.31),P<0.00001],more effective to reduce the abdominal distension symptom scores[MD=-0.35,95%CI(-0.63,-0.08),P=0.01],more effective to reduce serum level of interleukin-6[MD=-50.85,95%CI(-98.39,-3.32),P=0.04],the incidence of adverse reactions was lower[RR=0.33,95%CI(0.14,0.80),P=0.01],and the recurrence rate in follow-up period was also lower[OR=0.10,95%CI(0.01,0.86),P=0.04].Conventional western medicine therapy combined with acupoint application and moxibustion can significantly improve the total clinical effective rate[RR=1.21,95%CI(1.12,1.31),P<0.00001],and reduce the disease recurrence rate in the follow-up period[OR=0.17,95%CI(0.05,0.60),P=0.006].Reduced symptom score for epigastric pain[MD=-1.32,95%CI(-1.48,-1.16),P<0.00001],lower incidence of adverse reactions[RR=0.41,95%CI(0.16,1.03),P=0.06].Conclusion Acupoint application therapy has a high effectiveness in the treatment of CG,and can be combined with other therapies in clinical practice to assist in improving the efficacy.

关 键 词：穴位贴敷疗法 慢性胃炎 安全性 有效性 META分析 系统评价 

分 类 号：R246.1[医药卫生—针灸推拿学]