平息内风剂联合针刺治疗偏头痛疗效的meta分析  

Meta-analysis on efficacy of calming internal wind agent combined with acupuncture in treatment of migraine

作　　者：张瑞环 杨耀峰 郝涛 陈钧 Zhang Ruihuan;Yang Yaofeng;Hao Tao;Chen Jun(Department of Encephalopathy,Yulin Hospital of Traditional Chinese Medicine,Yulin 719000,China;Department of Acupuncture and Moxibustion,Yulin Hospital of Traditional Chinese Medicine,Yulin 719000,China;Department of Encephalopathy,Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi'an 710000,China)

机构地区：[1]榆林市中医医院脑病科,榆林719000 [2]榆林市中医医院针灸科,榆林719000 [3]陕西省中医医院脑病科,西安710000

出　　处：《国际医药卫生导报》2025年第4期552-558,共7页International Medicine and Health Guidance News

基　　金：陕西省自然科学基金(2023-JC-YB 656);陕西省中医药管理局重点项目(SZY-NLTL-2024-011);陕西省中医药管理局课题(2021-ZZ-JC018);榆林市科协青年人才托举计划(20230535)。

摘　　要：目的系统评价平息内风剂联合针刺治疗偏头痛的疗效。方法检索知网、万方、维普、SinoMed、PubMed、Web of Science、Cochrane Library、Embase,收集平息内风剂联合针刺治疗偏头痛的临床随机对照试验,检索时间为建库至2023年11月30日。选用RevMan5.4软件进行meta分析,GRADE分级系统评价观察指标的证据级别,TSA 0.9.5.1 Beta软件进行试验序贯分析。结果共纳入14项随机对照试验,1396例患者。Meta分析结果示:试验组的痊愈率高于对照组(RR=1.69,95%CI 1.43~1.99,P<0.00001),视觉模拟评分法(VSA)评分低于对照组(MD=-1.22,95%CI-1.56~-0.87,P<0.00001),头痛持续时间、头痛发作频次与对照组比较差异无统计学意义(MD=-1.71、-1.22,95%CI-4.04~0.62、-2.54~0.11,P=0.15、0.07)。GRADE证据分级:痊愈率为中级,总有效率、VAS评分均为低级,头痛持续时间、头痛发作频次均为极低级。总有效率的试验序贯分析示,纳入样本量均已达到meta分析所需要求,且排除假阳性可能;惩罚统计后的疗效结果可靠。结论平息内风剂联合针刺治疗偏头痛的临床疗效优于西药。Objective To systematically evaluate the efficacy of calming internal wind agent combined with acupuncture in the treatment of migraine.Methods CNKI,Wan Fang,VIP,SinoMed,PubMed,Web of Science,Cochrane Library,and Embase were searched to collect the clinical randomized controlled trials of calming internal wind agent combined with acupuncture in the treatment of migraine from their construction to 30 November 2023.The meta-analysis was performed using the RevMan5.4 software.The GRADE grading system was used to evaluate the evidence level of the observation indicators.The TSA 0.9.5.1 Beta software was used for sequential analysis of the trial.Results A total of 14 randomized controlled trials involving 1396 patients were included.The results of the meta-analysis showed that the cured rate in the experimental group was higher than that in the control group(RR=1.69,95%CI 1.43~1.99,P<0.00001);the score of Visual Analogue Scale(VAS)in the experimental group was lower than that in the control group(MD=-1.22,95%CI-1.56--0.87,P<0.00001);there were no statistical differences in the duration and frequency of headache between the experimental group and the control group(MD=-1.71,95%CI-4.04-0.62,P=0.15;MD=-1.22,95%CI-2.54-0.11,P=0.07).The results of GRADE evidence grading showed that the recovery rate was moderate;the total effective rate and score of VAS were low;the duration and frequency of headache were extremely low.The sequential analysis of the trials for total efficacy showed that the sample sizes included had met the requirements needed for the meta-analysis;the false positive possibility was ruled out;the efficacy results after penalization statistics were reliable.Conclusion The clinical efficacy of the combination of calming internal wind agent and acupuncture for migraine is better than that of western medicines.

关 键 词：偏头痛 平息内风剂 针刺 META分析 试验序贯分析 

分 类 号：R277.7[医药卫生—中医学]