火针为主治疗带状疱疹随机对照试验Meta分析
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摘要
【目的】对近10年火针为主治疗带状疱疹临床研究进行疗效和安全性的系统评价。【方法】通过中国知网(CNKI)、中国生物医学文献数据库(CBM)、重庆维普(VIP)、万方数据库和PubMed、荷兰医学文摘数据库(Embase)、美国临床医学期刊全文数据库(Ovid)、Cochrane图书馆(CL,Issue4,2006)中的Cochrane系统评价资料库(CDSR)及Cochrane对照试验注册资料库(CCTR)等中、英文数据库检索2007～2017年火针为主治疗带状疱疹的相关文献,使用RevMan5.3版进行统计分析。【结果】共检索到701篇文献,其中14篇符合纳入标准,使用改良后的Jadad评分标准对研究文献进行质量评价,评分显示所纳入研究文献均为中低质量文献。Meta分析结果显示,火针为主的治疗组在有效率[OR=4.66,95%CI(3.02,7.19)]和降低后遗神经痛发生率[OR=0.14,95%CI(0.07,0.26)]方面优于常规西药治疗的对照组,差异有统计学意义(P <0.000 01);但在缓解带状疱疹疼痛视觉模拟评分(VAS)[95%CI(-1.62,-1.31)]方面优势不明显。【结论】火针为主的治疗方法是治疗带状疱疹的安全有效方法,在总有效率、后遗神经痛发生率方面优于西医治疗方法,在即时止痛方面有优于西医西药的趋势,但VAS评分方面优势不明显。
Objective To evaluate the clinical efficacy and safety of clinical trials for herpes zoster mainly treatedwith fire needle therapy in recent 10 years. Methods We retrieved the clinical trials for herpes zoster mainly treatedwith fire needle therapy from Chinese databases of CNKI,Chinese biomedical literature database(CBM),Weipudatabase(VIP),Wanfang database,as well as English databases of PubMed,Embase,the full text database ofthe Journal of clinical medicine in the United States(Ovid),Cochrane system evaluation database(CDSR)andCochrane controlled trial registry database(CCTR)in the Cochrane library(CL,Issue 4,2006)issued in theyear of 2007 ～ 2017,and then made the quality evaluatin with RevMan 5.3 version. Results A total of 701 articleswere obtained,and 14 trials met the inclusion criteria. The quality of the research literature was evaluated by theimproved Jadad scoring system,and the results showed that the included trials were in low quality. The results ofthe Meta-analysis showed that the treatment group(mainly treated with fire needle therapy)had a higher overalleffective rate [OR = 4.66,95%CI(3.02,7.19)] and showed stronger effect on decreasing the incidence of postherpeticneuralgia [OR=0.14, 95% CI(0.07, 0.26)] than the control group(treated with western medicine), thedifferences being significant(P < 0.000 01), while had no obvious advantages on deccreasing the visual analogue scale(VAS)scores of herpes zoster pain[95%CI(-1.62,-1.31)]. Conclusion The fire needle therapyis safe and effective for the treatment of herpes zoster,and it is superior to western medicine in terms of enhancingoverall effective rate and decreasing the incidence of postherpetic neuralgia. It has a tendency to be superior towestern medicine in immediate pain relief,but the advantage of relieving VAS scores is not obvious.
Objective To evaluate the clinical efficacy and safety of clinical trials for herpes zoster mainly treatedwith fire needle therapy in recent 10 years. Methods We retrieved the clinical trials for herpes zoster mainly treatedwith fire needle therapy from Chinese databases of CNKI,Chinese biomedical literature database(CBM),Weipudatabase(VIP),Wanfang database,as well as English databases of PubMed,Embase,the full text database ofthe Journal of clinical medicine in the United States(Ovid),Cochrane system evaluation database(CDSR)andCochrane controlled trial registry database(CCTR)in the Cochrane library(CL,Issue 4,2006)issued in theyear of 2007 ～ 2017,and then made the quality evaluatin with RevMan 5.3 version. Results A total of 701 articleswere obtained,and 14 trials met the inclusion criteria. The quality of the research literature was evaluated by theimproved Jadad scoring system,and the results showed that the included trials were in low quality. The results ofthe Meta-analysis showed that the treatment group(mainly treated with fire needle therapy)had a higher overalleffective rate [OR = 4.66,95%CI(3.02,7.19)] and showed stronger effect on decreasing the incidence of postherpeticneuralgia [OR=0.14, 95% CI(0.07, 0.26)] than the control group(treated with western medicine), thedifferences being significant(P < 0.000 01), while had no obvious advantages on deccreasing the visual analogue scale(VAS)scores of herpes zoster pain[95%CI(-1.62,-1.31)]. Conclusion The fire needle therapyis safe and effective for the treatment of herpes zoster,and it is superior to western medicine in terms of enhancingoverall effective rate and decreasing the incidence of postherpetic neuralgia. It has a tendency to be superior towestern medicine in immediate pain relief,but the advantage of relieving VAS scores is not obvious.
引文
[1] Jadad A R,Moore A,Caoroll D,et al. Assessing the quality of reports of randomized clinical tirals:is blind in necessary[J].Control Clin Trials,1996,17(1):1.
[2]梁万年.医学科研方法学[M].北京:人民卫生出版社,2002:451-448.
[3]曾丽.“毫火针”结合闪罐治疗带状疱疹的临床观察[J].实用医院临床杂志,2015,12(1):149.
[4]陈霞.高密度火针点刺法治疗带状疱疹44例疗效观察[J].新疆中医药,2014,32(4):49.
[5]姜福琼,王晓琼,汪艳梅,等.毫火针配合红光治疗带状疱疹29例疗效观察[J].云南中医中药杂志,2015,36(11):51.
[6]范玉江,刘清国,尹改珍.毫火针围点刺配合药物治疗带状疱疹疗效观察[J].上海针灸杂志,2013,32(2):118.
[7]陈纯涛,陈明岭,唐定书,等.火针治疗带状疱疹50例临床观察[J].时珍国医国药,2007,18(8):1842.
[8]李丽丽,毛立亚.毫火针配合围针刺法治疗中老年带状疱疹33例临床观察[J].甘肃中医药大学学报,2016,33(5):54.
[9]黄政德,范华.火针配合青黛散治疗急性期带状疱疹30例疗效观察[J].云南中医中药杂志,2013,34(7):52.
[10]马新平,姜燕.毫针、火针与拔罐综合治疗带状疱疹疗效观察[J].中国中医急症,2009,18(1):49.
[11]杨文祥,蒋冬玲.火针联合拔罐治疗带状疱疹30例临床观察[J].亚太传统医药,2015,11(4):96.
[12]张晓,王强强.火针、电针结合排刺治疗带状疱疹急性期50例[J].浙江中西医结合杂志,2016,26(2):138.
[13]李涛,任景,张庆.火针联合刺络拔罐治疗带状疱疹50例临床疗效观察[J].中国社区医师,2015,31(21):90.
[14]张桂波,王为龙,鲍春龄,等.火针为主治疗带状疱疹疗效观察[J].上海针灸杂志,2014,33(5):439.
[15]杨青宇,陈蕴熙.火针配合刺络拔罐治疗带状疱疹临床效果评价[J].现代诊断与治疗,2016,27(7):1201.
[16]王映辉,黄石玺,刘保延,等.火针赞刺法治疗带状疱疹的临床疗效评价研究[J].中国中医基础医学杂志,2009,15(10):774.
[17]赵辩.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:397.
[18]白耀辉,林文任.艾灸与温热刺激关系的探讨[J].针灸学报,1991,7(4):10.
[19]阮怀珍,李希成. P物质参与伤害性刺激诱发的脊髓c-fos表达[J].科学通报,1994,39(13):1237.
[20]李久宏,郭英军,尚英彬,等.老年带状疱疹患者血浆三种神经肽的检测[J].中华皮肤科杂志,2006,39(7):410.
[2]梁万年.医学科研方法学[M].北京:人民卫生出版社,2002:451-448.
[3]曾丽.“毫火针”结合闪罐治疗带状疱疹的临床观察[J].实用医院临床杂志,2015,12(1):149.
[4]陈霞.高密度火针点刺法治疗带状疱疹44例疗效观察[J].新疆中医药,2014,32(4):49.
[5]姜福琼,王晓琼,汪艳梅,等.毫火针配合红光治疗带状疱疹29例疗效观察[J].云南中医中药杂志,2015,36(11):51.
[6]范玉江,刘清国,尹改珍.毫火针围点刺配合药物治疗带状疱疹疗效观察[J].上海针灸杂志,2013,32(2):118.
[7]陈纯涛,陈明岭,唐定书,等.火针治疗带状疱疹50例临床观察[J].时珍国医国药,2007,18(8):1842.
[8]李丽丽,毛立亚.毫火针配合围针刺法治疗中老年带状疱疹33例临床观察[J].甘肃中医药大学学报,2016,33(5):54.
[9]黄政德,范华.火针配合青黛散治疗急性期带状疱疹30例疗效观察[J].云南中医中药杂志,2013,34(7):52.
[10]马新平,姜燕.毫针、火针与拔罐综合治疗带状疱疹疗效观察[J].中国中医急症,2009,18(1):49.
[11]杨文祥,蒋冬玲.火针联合拔罐治疗带状疱疹30例临床观察[J].亚太传统医药,2015,11(4):96.
[12]张晓,王强强.火针、电针结合排刺治疗带状疱疹急性期50例[J].浙江中西医结合杂志,2016,26(2):138.
[13]李涛,任景,张庆.火针联合刺络拔罐治疗带状疱疹50例临床疗效观察[J].中国社区医师,2015,31(21):90.
[14]张桂波,王为龙,鲍春龄,等.火针为主治疗带状疱疹疗效观察[J].上海针灸杂志,2014,33(5):439.
[15]杨青宇,陈蕴熙.火针配合刺络拔罐治疗带状疱疹临床效果评价[J].现代诊断与治疗,2016,27(7):1201.
[16]王映辉,黄石玺,刘保延,等.火针赞刺法治疗带状疱疹的临床疗效评价研究[J].中国中医基础医学杂志,2009,15(10):774.
[17]赵辩.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:397.
[18]白耀辉,林文任.艾灸与温热刺激关系的探讨[J].针灸学报,1991,7(4):10.
[19]阮怀珍,李希成. P物质参与伤害性刺激诱发的脊髓c-fos表达[J].科学通报,1994,39(13):1237.
[20]李久宏,郭英军,尚英彬,等.老年带状疱疹患者血浆三种神经肽的检测[J].中华皮肤科杂志,2006,39(7):410.