摘要
目的系统评价针灸治疗慢性萎缩性胃炎的临床疗效。方法检索数据库查找有关针灸治疗慢性萎缩性胃炎的临床随机对照试验(RCT)和半随机对照试验(CCT),对纳入的研究进行质量评价、提取资料及统计分析。结果共纳入19篇文献,合计1502例患者。Meta分析结果显示针药并用、穴位注射治疗萎缩性胃炎的总有效率优于常规药物组[OR=5.80,95%CI(2.33,14.40)][OR=2.70,95%CI(1.34,5.45)];穴位注射、温针灸及针药并用治疗萎缩性胃炎的胃镜检查有效率与药物组比较有统计学差异[OR=2.71,95%CI(1.59,4.63)][OR=3.40,95%CI(1.82,6.36)][OR=4.31,95%CI(1.01,18.46)];在对病理检查有效率的比较中,发现温针灸疗法与对照组比较差异具有统计学意义[OR=1.94,95%CI(1.13,3.33)];在清除幽门螺旋杆菌上,针灸治疗与药物治疗效果无明显差异。温针灸疗法还能够改善患者总体健康感、生命活力和心理健康,提高患者生存质量。结论与药物治疗相比,针灸疗法在提高慢性萎缩性胃炎患者总体有效率、胃镜检查有效率及病理活检有效率方面具有一定的疗效。但由于本次系统评价纳入研究的数量有限,且纳入研究存在高风险的选择性偏倚、实施性及测量性偏倚,纳入研究的质量不高,因此需慎重对待系统评价结果。
Objective To evaluate the clinical efficacy of acupuncture in treating chronic atrophic gastritis. Methods Databases were searched to find clinical randomized controlled trials（RCT） and quasi-randomized controlled trials（q RCT） of acupuncture treatment for chronic atrophic gastritis. The included studies were qualitatively assessed. The data were collected and statistically analyzed. Results A total of 19 pieces of literature were included with a total of 1502 patients. A meta-analysis showed that the total efficacy rates of combined acupuncture and medicine, and acupuncture point injection for chronic atrophic gastritis were higher than that of routine medication [OR=5.80, 95% CI（2.33,14.40）] and [OR=2.70,95% CI（1.34,5.45）]; the gastroscopic efficacy rates of acupuncture point injection, warm needling moxibustion and combined acupuncture and medicine for chronic atrophic gastritis were statistically different from that of medication as a control [OR=2.71, 95% CI（1.59,4.63）], [OR=3.40, 95% CI（1.82,6.36）] and [OR=4.31, 95% CI（1.01,18.46）]; there was a statistically significant difference in the pathological efficacy rate between the warm needling moxibustion and the control groups [OR=1.94, 95% CI（1.13,3.33）]; there was no statistically significant difference in eliminating helicobacter pylori between acupuncture and medication. Warm needling moxibustion could also improve general health perceptions, the vitality of life, mental health and the quality of life in patients. Conclusions Acupuncture increases the overall, gastroscopic and pathological efficacy rates compared with medication. The results of this systematic review needs to be cautiously considered because the number of the studies included for this systematic review is limited, the included studies have a high risk of selection bias, performance bias and detection bias, and the quality of included studies is not high.
出处
《上海针灸杂志》
2016年第7期886-892,共7页
Shanghai Journal of Acupuncture and Moxibustion
基金
上海市"杏林新星"培养计划项目(ZYSNXDOII-RC-XLXX-20130041)
关键词
针灸疗法
胃炎
萎缩性
系统评价
文献研究
META分析
Acupuncture therapy
Gastritis
atrophic
Systematic review
Literature study
Meta-analysis
