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针灸治疗糖尿病胃轻瘫疗效的Meta分析(PDF)

《云南中医学院学报》[ISSN:1000-2723/CN:53-1048/R]

期数:
2021年01期
页码:
51-59
栏目:
针灸研究
出版日期:
2021-06-28

文章信息/Info

Title:
Meta-analysis of Therapeutic Effect of Acupuncture and Moxibustion on Diabetic Gastroparesis
文章编号:
1000-2723(2021)01-0051-09
作者:
刘冰洋1裴丽霞1 2陈 昊3孙建华1 2△
(1. 南京中医药大学附属医院,江苏 南京 210000;2. 中国中医药循证医学中心针灸疾病项目组,江苏 南京 210000;3. 南京中医药大学针灸推拿学院·养生康复学院,江苏 南京 210000)
Author(s):
LIU Bingyang1 PEI Lixia12 CHEN Hao3 SUN Jianhua12
(1. The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China; 2. Project of Building Evidence based Practice Capacity for TCM, Nanjing 210000, China; 3. School of Acupuncture and Tuina, School of Regimen and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing 210000, China)
关键词:
糖尿病胃轻瘫针灸疗法系统评价Meta分析
Keywords:
diabetic gastroparesis acupuncture and moxibustion systematic review Meta-analysis
分类号:
R246.1
DOI:
10.19288/j.cnki.issn.1000-2723.2021.01.007
文献标识码:
A
摘要:
目的系统评价近6年针灸治疗糖尿病胃轻瘫的疗效。方法 计算机检索中国知网学术期刊全文数据库、维普中文期刊数据库、万方数据库、CBM、Pubmed、Embase、Cochrane Library,收集整理针灸治疗糖尿病胃轻瘫的随机对照试验。检索时限从2015年3月到2021年1月。2名研究者按照Cochrane Handbook 5.1.0标准对纳入试验进行偏倚风险评估,使用RevMan 5.3软件进行Meta分析。结果 共纳入16个研究,合计1 403例患者。Meta分析结果显示,针灸组对照西医组临床症状改善[总体有效率RR=1.23,95%CI(1.17,1.29),P<0.000 01],亚组分析显示,针刺、电针、温针灸总有效率高于西医组,且最佳干预可能性大小为电针(1.30)>温针(1.28)>针刺(1.2);症状积分的可信区间较窄,效应方向一致均指向针灸组且和无效线不相交;小钡条胃内残留量少[WMD=-3.11, 95%CI(-3.43,-2.80),P<0.000 01];针灸组降低血中胃泌素和胃动素的效果更明显[WMD=-28,95%CI (-45.92, -10.07),P<0.000 01]、[WMD=-82.66,95%CI(-115.78,-49.55),P<0.000 01]。有5篇文章涉及到39例不良反应的出现,其中针灸组18例,西医组21例。结论 针灸治疗糖尿病胃轻瘫临床疗效优于常规西医治疗,可改善患者的临床症状和胃动力。亟待高质量、大样本RCT进一步的验证。
Abstract:
Objective To systematically evaluate the efficacy of acupuncture-moxibustion in the treatment of diabetic gastroparesis in recent 6 years. Methods The CNKI, VIP, WanFang, CBM, Pubmed, Embase, Cochrane Library databases were searched. Randomized controlled trials on acupuncture-moxibustion on diabetic gastroparesis were screened. The retrieval time was from March of 2015 to January of 2021. Two researchers assessed risk of bias included in the test according to the Cochrane Handbook 5.1.0 standard, and used RevMan 5.3 software for Meta analysis. Results A total of 16 RCTs involving 1403 patients were included. Meta-analysis showed that the total effective rate of clinical symptoms were improved in the acupuncture-moxibustion group compared with the western medicine group [RR=1.23, 95%CI(1.17,1.29), P<0.000 01)]. The subgroup analysis showed that the total effective rate of acupuncture, electroacupuncture and needle warming moxibustion was higher than that of the western medicine group, and the best possibility of intervention is electroacupuncture(1.30) > needle warming moxibustion(1.28) > acupuncture(1.2). The confidence interval of symptom scores was narrow, and the effect direction was consistent with the acupuncture-moxibustion group and did not intersect with the invalid line. The gastric residue of small barium strips was less [WMD=-3.11 ,95%CI(-3.43,-2.80), P<0.000 01)]. The effect of reducing gastrin and motilin in the acupuncture-moxibustion group was more obvious [WMD=-28,95%CI(-45.92,-10.07), P<0.000 01]、[WMD=-82.66,95%CI(-115.78,-49.55), P<0.000 01]. There were 5 articles about 39 cases of adverse events, including 18 cases in acupuncture-moxibustion group and 21 cases in western medicine group. Conclusion Acupuncture-moxibustion is better than conventional western medicine in treating diabetic gastroparesis, which can improve the clinical symptoms and gastric motility of patients. Further verification of high quality and large sample RCT is urgently needed.

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备注/Memo

备注/Memo:
收稿日期: 2021 - 01- 25基金项目: 国家中医药管理局“中医药循证能力建设项目”(2019XZZX-ZJ008);江苏省中医药管理局领军人才项目(SLJ0206);江苏省中医院院级高峰人才项目(y2018rc05)第一作者简介: 刘冰洋(1994-),女,在读硕士研究生,研究方向:针灸治疗消化系统疾病的研究应用.△通信作者: 孙建华,E-mail:drjhsun@qq.com
更新日期/Last Update: 1900-01-01