针刺治疗后循环缺血性眩晕疗效及其安全性的Meta分析  

A Meta analysis of efficacy and safety of acupuncture posterior circulation ischemic vertigo

作　　者：俞雅婷 郭栋[1] 王丹丹[1] 黄文文 YU Yating

机构地区：[1]山东中医药大学,山东济南250000

出　　处：《中医临床研究》2024年第14期61-68,共8页Clinical Journal Of Chinese Medicine

基　　金：山东省中医药科技项目(Z-2023027T)。

摘　　要：目的:运用Meta分析的方式,研究针刺治疗后循环缺血性眩晕的有效性和安全性。方法:检索PUBMED、EMBASE、Cochrane图书馆、中国生物医学文献数据库(CBM)、国家知识基础设施数据库、万方数据库和中国科技期刊全文数据库中关于针刺治疗后循环缺血性眩晕的随机对照试验,检索时间限定为各数据库建库至2023年11月。导入至EndNote20进行筛除,采用“Cochrane风险偏倚评估”工具对纳入研究进行方法学质量评价,运用Stata 16.0软件进行Meta分析。结果:最终纳入文献为29篇,总样本量2120例。Meta分析结果显示:针刺治疗或辅助治疗后循环缺血性眩晕相对于对照组能显著提高临床疗效[RR=1.14,95%CI(1.11,1.19),P<0.01],改善患者眩晕症状(MD=-9.20,95%CI[-13.19,-5.21],P<0.01),改善左侧椎动脉、右侧椎动脉、基底动脉的平均流速指标,加快峰值流速,并减少三条后循环血管的搏动指数(Pulsation Index,PI)。且不论是针灸治疗还是中药西药治疗或联合治疗,其不良反应均较轻,表明针刺治疗后循环缺血的安全性与常规治疗相当。结论:针刺治疗后循环缺血性眩晕具有较好的临床疗效,且有一定的安全性。但受限于纳入研究质量和方法学,导致检验效能不足,存在一定程度的临床异质性,将来仍需进行更高质量的随机对照试验,以进一步验证其疗效。Objective:To investigate the efficacy and safety of acupuncture in the treatment of post circulation ischemic vertigo by means of Meta-analysis.Methods:We searched PUBMED,EMBASE,Cochrane Library,Chinese Biomedical Literature Database(CBM),National Knowledge Infrastructure Database,Wanfang Database,and Chinese Science and Technology Journal full-text database for randomized controlled trials on circulatory ischemic vertigo after acupuncture treatment.The search time is limited to the establishment of each database until November 2023.The studies were imported into EndNote20 for screening.The Cochrane risk bias assessment tool was used to evaluate the methodological quality of the included studies,and Stata 16.0 software was used for Meta�analysis.Results:29 literatures were included,with a total sample size of 2120 people.The results of meta-analysis showed:Compared with the control group,acupuncture therapy or adjuvant therapy could significantly improve the clinical efficacy(RR=1.14,95%CI[1.11,1.19],P<0.01)and improve the vertigo symptoms(MD=-9.20,95%CI[-13.19,-5.21],P<0.01).The average flow velocity of the left vertebral artery,right vertebral artery and basilar artery was improved,the peak flow velocity was accelerated,and the pulsation index of the three posterior circulation vessels was reduced.In addition,the adverse reactions of acupuncture,traditional Chinese medicine or combined treatment were mild,indicating that the safety of circulating ischemia after acupuncture treatment is comparable to that of conventional treatment.Conclusion:Acupuncture has good clinical effect and safety in the treatment of post-circulation ischemic vertigo.However,limited by the quality and methodology of the included studies,the efficacy of the test is insufficient,and there is a certain degree of clinical heterogeneity.In the future,higher quality randomized controlled trials are still needed to further verify its efficacy.

关 键 词：后循环缺血 针刺 后循环缺血性眩晕 

分 类 号：R255.4[医药卫生—中医内科学]