针药结合治疗溃疡性结肠炎疗效评价研究  

Systematic Evaluation of Acupuncture Combined with Medicine in Treatment of Ulcerative Colitis

作　　者：张永跟[1] 颜小飞 胡红昊 刘兰林[1] 何明[3] 李学军[2] ZHANG Yonggen;YAN Xiaofei;HU Honghao;LIU Lanlin;HE Ming;LI Xuejun(Anhui University of Traditional Chinese Medicine,Anhui Hefei 230012,China;The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Anhui Hefei 2300621,China;Dongfang Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100078,China)

机构地区：[1]安徽中医药大学,安徽合肥230012 [2]安徽中医药大学第二附属医院,安徽合肥230061 [3]北京中医药大学东方医院,北京100078

出　　处：《中医药临床杂志》2024年第6期1110-1119,共10页Clinical Journal of Traditional Chinese Medicine

基　　金：安徽中医药大学博士后岗位人才项目(RD17100570);安徽省高等学校省级质量工程项目(2020jyxm1017);安徽中医药大学校级纵向探索课题(2021zxts42);安徽中医药大学校级教研课题(2019xjjy_yb008);安徽省精品资源共享课资助项目(2012gxk063);全国第四批中医优秀人才研修项目。

摘　　要：目的:评价针药结合治疗溃疡性结肠炎(UC)的临床疗效和安全性。方法:检索与主题相关的随机对照试验的文献,纳入的文献按不同治疗目标进行讨论,Cochrane协作网的偏倚风险评估工具评价纳入文献的质量,并对相应的文献作系统评价。结果:共纳入文献23篇。结果为:针药结合治疗组与常规治疗对照组相比,有效率为结局指标,其合并OR 4.81,95%CI[3.63,6.37];中医证候学指标,腹痛、腹泻、脓血便为结局指标,其合并SMD分别为-0.92、-1.93、-1.68,95%CI分别为[-1.34,-0.50]、[-2.94,-0.92]、[-2.67,-0.70];Geboes量表评分为结局指标,其SMD为-3.09,95%CI[-8.06,1.89];患者满意度为结局指标,其RR为1.26,95%CI为[1.09,1.45];结局指标为住院费用,其SMD为-9.93,95%CI[-11.83,-8.56];结局指标为住院时间,其MD为-20.39,95%CI[-32.70,-8.07]。上述两组各指标比较,除外Geboes量表评分方面无显著性差异,其余各项结局指标均有显著性差异。结论:本系统评价结果表明针药结合治疗UC可以显著提高临床疗效,明显改善腹痛、腹泻、脓血便等临床表现,提高患者就诊的满意度,减少住院时间,降低住院费用,临床治疗未出现严重的不良反应,因此针药结合治疗是治疗本病的最佳组合。由于纳入研究质量相对较低,仍需要开展更多、质量更高的研究,并进行进一步分析。Objective:To asess the efficacy and safety of acupuncture combined with western medicine in treatment of ulcerative colitis (UC). Method:The randomized controlled trials of combined acupuncture and medication for UC were collected, and the included literatures were stratified according to different treatment strategies. The quality of included literatures was evaluated by the Cochrane collaboration's bias risk assessment tool, and included literatures were systematically evaluated. Results:A total of 23 articles met the inclusion criteria. The results of meta-analysis suggested that the effective rate was the outcome index of the combined acupuncture and drug therapy group compared with the conventional treatment group, and the combined OR was 4.81, 95% CI[3.63,6.37]. Syndrome indicators of traditional Chinese medicine, abdominal pain, diarrhea, pus and blood stools were outcome indicators, and their combined SMD was -0.92, -1.93, -1.68, 95%CI was [-1.34,-0.50], [-2.94,-0.92], [-2.67,-0.70], respectively. Geboes scale score was the outcome index, and its SMD was -3.09, 95% CI[-8.06,1.89]. Patient satisfaction was the outcome index, RR was 1.26, 95% CI was [1.09,1.45]. The outcome index was hospitalization expense, SMD was -9.93, 95% CI[-11.83, -8.56]. The outcome index was length of stay, and MD was -20.39, 95% CI[-32.70, -8.07]. All the indicators of the two groups were compared, except that there was no significant difference in the Geboes scale score, and all the other outcome indicators were statistically significant. Conclusion: The evaluation results of this system showed that the combination of acupuncture and drug therapy for UC could significantly improve the clinical ef-ficacy, significantly improve the clinical manifestations of abdominal pain, diarrhea, pus and blood stools, improve the satisfaction of patients, reduce the length of stay in hospital, reduce the cost of hospitalization, and no serious adverse reactions were observed, Therefore, acupuncture and medicine combination therapy is the best c

关 键 词：针药结合 溃疡性结肠炎 随机对照试验 系统评价 META分析 

分 类 号：R256.3[医药卫生—中医内科学]