不同针灸疗法治疗骨质疏松症的网状Meta分析  

A network Meta-analysis of different acupuncture therapies in the treatment of osteoporosis

作　　者：齐士坤 张秀芳[2] 朱梦霞 李淑贤 冯倩[1] 王楠[1] 徐明明[2] QI Shikun

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院,广东深圳518033

出　　处：《中医临床研究》2024年第17期114-123,共10页Clinical Journal Of Chinese Medicine

基　　金：广东省中医药局科研立项项目(20231298)。

摘　　要：目的:运用网状Meta分析评价针灸治疗原发性骨质疏松的临床疗效。方法:计算机检索PubMed、Cochrane Library、Embase、中国知网、万方数据库、维普期刊资源数据库和中国生物医学文献数据库。检索时限为建库至2023年4月30日。结局指标包括骨密度、视觉模拟评分、总有效率。文献筛选、资料提取及偏倚风险评价均由两名研究者独立进行。数据分析使用Stata 16.0软件。结果:共纳入33篇随机对照试验文献,包含2773例患者,数据分析结果显示,在增加骨密度方面疗效排名前3者为穴位埋线、穴位注射与温针灸;银质针、温针灸、穴位注射在降低视觉模拟评分方面疗效排名前3;在治疗骨质疏松有效率方面,银质针、温针灸、穴位埋线疗效排名前3。综合3项指标的网状Meta分析结果,在增加骨密度方面穴位埋线疗效最优,在缓解疼痛与治疗有效率方法银质针效果最优。结论:穴位埋线、银质针与温针灸均能有效治疗骨质疏松,提升骨密度,缓解疼痛,但需更高质量的大样本研究证实。Objective:To evaluate the clinical efficacy of acupuncture in the treatment of primary osteoporosis using reticulated Meta-analysis.Methods:Computerized searches were performed on PubMed,Cochrane Library,Embase English literature databases and China Knowledge Network,Wanfang Database,Wipu Journal Resource Database and China Biomedical Literature Database.The search time limit was from the establishment of the database to 30 April 2023.The outcome indicators included bone mineral density,visual analogue score,and overall effective rate.Literature screening,data extraction,and risk of bias evaluation were performed independently by two investigators.Data was analyzed using Stata 16.0 software.Results:A total of 33 RCTs containing 2773 patients were included.The results of data analysis showed that the top 3 in terms of efficacy in increasing bone mineral density were acupoint catgut embedding,acupoint injection and warm acupuncture;the top 3 in terms of efficacy in decreasing VAS scores were silver acupuncture,warm acupuncture and acupoint injection;and in terms of efficacy in the treatment of osteoporosis,the top 3 were silver acupuncture,warm acupuncture and acupoint catgut embedding.The results of reticulated Meta-analysis for the combined 3 indicators showed that acupoint catgut embedding had the best efficacy in increasing bone mineral density,and silver needles had the best efficacy in relieving pain and the effective rate.Conclusion:Acupoint catgut embedding,silver needles and warm acupuncture are all effective in treating osteoporosis,improving bone mineral density and relieving pain,but need to be confirmed by higher quality,large sample studies.

关 键 词：针灸 骨质疏松 随机对照试验 网状Meta分析 

分 类 号：R245[医药卫生—针灸推拿学]