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针刺治疗过敏性鼻炎系统评价和meta分析
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Journal Article
针刺治疗过敏性鼻炎系统评价和meta分析
2016
Overview
目的：分析评价单纯针刺（包含单纯电针）对过敏性鼻炎（AR）的临床疗效,并与抗组胺药物治疗以及中成药鼻炎康片治疗进行对照观察。方法：按照循证医学的要求,制定原始文献的检索策略、纳入标准及排除标准,检索中国知网（CNKI）、万方学术期刊全文数据库（Wanfang）、重庆维普数据库（CQVIP）、中国生物医学文献数据库（CBM）、Pub Med、荷兰医学文摘（EMBASE）、科学网、Cochrane图书馆和Cochrane随机对照试验注册中心中1990年1月至2015年12月间针刺治疗AR的随机对照（RCTs）临床研究文献,以Cochrane系统评价手册5.1进行质量评价,采用Rev Man 5.3对纳入文献进行meta分析。结果：共20篇文献符合纳入标准。meta分析显示,针刺与抗组胺药物比较,合并RR=1.24〉1,95%CI[1.15,1.33],P〈0.00001,提示针刺治疗AR临床总有效率优于抗组胺药物;合并MD=–0.93〈0,95%CI[–1.22,–0.63],P〈0.00001,提示针刺降低AR患者鼻部症状评分的效果优于抗组胺药物;合并MD=1.46〉0,95%CI[–10.84,13.75],P=0.82,提示针刺对AR患者血清免疫球蛋白E（Ig E）的影响与抗组胺药物无统计学差异。针刺与中成药鼻炎康片比较,合并RR=1.50〉1,95%CI[1.30,1.73],P〈0.00001,提示针刺治疗AR临床总有效率优于口服鼻炎康片。结论：单纯针刺治疗AR临床总有效率优于抗组胺药物治疗和中成药鼻炎康治疗,同时对于改善AR患者临床症状评分也优于抗组胺药物治疗,但从现有数据无法得知是否优于中成药鼻炎康片。在改善血清Ig E方面,目前数据显示,单纯针刺效果与抗组胺药物治疗无统计学差异,有待进一步研究。在所纳入的随机对照临床文献中,随机方法不详,盲法实施缺失,造成一定的偏倚风险,因此降低了整体结论的证据级别。
