电针治疗特发性面神经麻痹急性期疗效的系统评价
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摘要
【目的】系统评价电针在特发性面神经麻痹急性期的治疗作用。【方法】采用计算机检索中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、万方数据知识服务平台Wanfang、维普期刊全文数据库(VIP),并采用手工检索方式查阅国内主要的针灸学杂志,依据纳入标准与排除标准,筛选电针治疗特发性面神经麻痹急性期的临床对照试验。参照Cochrane评价员手册进行文献质量评价,采用Rev Man 5.3软件进行Meta分析。【结果】最终纳入符合标准的文献16篇。Meta分析结果表明:2组基于3种疗效评定标准的治愈率比较,观察组均优于对照组,差异有统计学意义(P<0.05或P<0.01);2组治愈所需天数、1个月痊愈例数、瞬目反射测定、并发症例数等指标比较,观察组亦均优于对照组,差异有统计学意义(P<0.01)。【结论】电针在特发性面神经麻痹急性期治疗作用确切,但由于纳入研究数量和质量有限,上述结论仍待更多高质量大样本长期随访的研究予以证实。
Objective To make a systematic review of therapeutic effect of electroacupuncture(EA)for idiopathic facial palsy at acute stage. Methods With reference to the included criteria and excluded criteria, clinical controlled trials of EA for idiopathic facial palsy at acute stage were screened from the databases of CBM,CNKI,Wanfang,VIP by computer retrieval and from the primary domestic academic journals of acupuncture by manual retrieval. Systematic review was performed following the Cochrane Reviewers' Handbook,and Rev Man5.3 was used for Meta-analysis. Results Sixteen clinical trials were included. The Meta-analysis results showed that the cure rate evaluated with 3 kinds of therapeutic effect criteria in the observation group was superior to that of the control group,the difference being significant(P < 0.05 or P < 0.01);the effects on improving days for cure, cure case number within one month, blink reflex, and case number with complications in the observation group were also superior to that of the control group, the difference being significant(P < 0.01).Conclusion EA exerts certain therapeutic effect for idiopathic facial palsy at acute stage. But for the quantity and quality of the included trials are not satisfactory,the conclusion still needs more high-quality, large-size and long-term follow-up trials to verify.
Objective To make a systematic review of therapeutic effect of electroacupuncture(EA)for idiopathic facial palsy at acute stage. Methods With reference to the included criteria and excluded criteria, clinical controlled trials of EA for idiopathic facial palsy at acute stage were screened from the databases of CBM,CNKI,Wanfang,VIP by computer retrieval and from the primary domestic academic journals of acupuncture by manual retrieval. Systematic review was performed following the Cochrane Reviewers' Handbook,and Rev Man5.3 was used for Meta-analysis. Results Sixteen clinical trials were included. The Meta-analysis results showed that the cure rate evaluated with 3 kinds of therapeutic effect criteria in the observation group was superior to that of the control group,the difference being significant(P < 0.05 or P < 0.01);the effects on improving days for cure, cure case number within one month, blink reflex, and case number with complications in the observation group were also superior to that of the control group, the difference being significant(P < 0.01).Conclusion EA exerts certain therapeutic effect for idiopathic facial palsy at acute stage. But for the quantity and quality of the included trials are not satisfactory,the conclusion still needs more high-quality, large-size and long-term follow-up trials to verify.
引文
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[21]杨万章,吴芳,张敏.周围性面神经麻痹的中西医结合评定及疗效标准(草案)[J].中西医结合心脑血管病杂志,2005,3(9):786.
[22]陈荣钟,陈耀龙,陈淑慧.“网络透穴”针法治疗顽固性周围性面瘫的临床疗效评价研究[J].中国中医基础医学杂志,2014,20(7):967.
[23]郑诗旭,刘志顺.面瘫电针应用刍议[J].中国针灸,2015,35(2):200.
[24]孙运花,李瑛,张薇,等.急性期电针对面神经损伤模型兔JAK1-STAT3信号通路的影响[J].辽宁中医杂志,2012,39(2):368.
[25]孙运花,李瑛,张薇,等.急性期电针对面神经损伤模型兔CNTFR表达的影响[J].辽宁中医杂志,2011,38(11):2271.
[26]孙运花,李瑛,彭晓华,等.急性期电针对面神经损伤模型兔的影响[J].时珍国医国药,2011,22(11):2776.
[2]潘江,章薇,陈武善,等.针刺治疗周围性面瘫(急性期)的系统评价[J].针灸临床杂志,2011,27(4):60.
[3]林敏.周围性面瘫急性期电针治疗引起并发症临床研究[J].中医学报,2011,26(10):1275.
[4]程显丹.急性期进行针灸联合电针治疗小儿急性面神经炎疗效观察[J].中国中西医结合儿科学,2016,8(1):21.
[5]江进忠.穴位透刺配合电针治疗急性期周围性面瘫的临床疗效观察[J].中医临床研究,2014,6(7):62.
[6]刘瑞华.电针治疗周围性面瘫急性期临床观察[J].实用中医药杂志,2014,30(1):46.
[7]桑久华,孙丽艳.电针浅刺治疗急性期周围性面瘫疗效观察[J].上海针灸杂志,2013,32(9):715.
[8]赵文兰.电针配合药物治疗周围性面瘫82例临床疗效观察[J].四川中医,2013,31(3):117.
[9]佟卓增.低频电刺激治疗面神经炎的临床观察[D].哈尔滨:黑龙江中医药大学,2012.
[10]陈能章,梁才雄,黄雪芬.电针治疗周围性面神经麻痹急性期临床观察[J].中国当代医药,2011,18(11):85.
[11]张建平.电针治疗早期周围性面瘫93例[J].江西中医药,2010,41(9):70.
[12]刘立安,朱在波,戚其华,等.周围性面瘫急性期不同干预方法疗效比较[J].中国针灸,2010,30(12):989.
[13]张中一,刘茵.电针干预急性期周围性面瘫临床疗效观察[J].上海针灸杂志,2009,28(9):517.
[14]张树新.面部透针加电针治疗周围性面瘫的临床观察[J].北京中医药,2008,27(9):720.
[15]瞿群威,熊涛.电针治疗不同病期周围性面瘫的临床观察[J].中国针灸,2005,25(5):323.
[16]陈颖,王麟鹏,刘志凌.Bell’s面瘫急性期电针灸与激素治疗临床对照观察[J].北京中医,2004,23(2):105.
[17]郑利星.电针治疗面神经炎时机选择刍议[J].现代中西医结合杂志,2003,12(2):173.
[18]李晓宁.电针治疗周围性面瘫的临床研究[D].哈尔滨:黑龙江中医药大学,2002.
[19]王仲伟.早期辨证应用电针治疗周围性面瘫48例[J].江苏中医,2001,22(10):41.
[20]国家中医药管理局.中医病症诊断疗效标准[S].南京:南京大学出版社,1994:189-190.
[21]杨万章,吴芳,张敏.周围性面神经麻痹的中西医结合评定及疗效标准(草案)[J].中西医结合心脑血管病杂志,2005,3(9):786.
[22]陈荣钟,陈耀龙,陈淑慧.“网络透穴”针法治疗顽固性周围性面瘫的临床疗效评价研究[J].中国中医基础医学杂志,2014,20(7):967.
[23]郑诗旭,刘志顺.面瘫电针应用刍议[J].中国针灸,2015,35(2):200.
[24]孙运花,李瑛,张薇,等.急性期电针对面神经损伤模型兔JAK1-STAT3信号通路的影响[J].辽宁中医杂志,2012,39(2):368.
[25]孙运花,李瑛,张薇,等.急性期电针对面神经损伤模型兔CNTFR表达的影响[J].辽宁中医杂志,2011,38(11):2271.
[26]孙运花,李瑛,彭晓华,等.急性期电针对面神经损伤模型兔的影响[J].时珍国医国药,2011,22(11):2776.