摘要
目的:系统评价针刺治疗原发性骨质疏松症(PO)的疗效和安全性。方法:广泛收集针刺或针刺+西药治疗对比西药的临床研究,纳入体针、腹针、电针治疗PO的随机试验。计算机检索中国知网(CNKI)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库、Pub Med、Cochrane Library、Web of Science、EMBASE数据库,文献检索时间为建库至2015年9月1日。语言及发表形式不限。纳入的文献均据改良Jadad评分进行质量评价。对临床异质性较小的文献采用Rev Man 5.3进行Meta分析。结果:共纳入17项研究,合计1369例PO患者,平均年龄为63.32岁。Meta分析示:对比西药,针刺治疗在有效率(OR=3.21;95%CI:1.99~5.18;P<0.00001)、降低疼痛评分(MD=-0.75;95%CI:-1.17^-0.32;P=0.0005)方面均具有统计学意义,在提高腰椎骨密度方面无统计学意义(MD=0.03;95%CI:-0.00^-0.07;P=0.08);针刺+西药治疗在有效率(OR=3.92;95%CI:2.43~6.31;P<0.00001)、降低疼痛评分(MD=-1.71;95%CI:-2.22^-1.20;P<0.00001)、提高腰椎骨密度(MD=0.09;95%CI:0.08~0.11;P<0.00001)方面均有统计学意义,但在提高股骨颈骨密度方面,两者无统计学意义(MD=0.00;95%CI:-0.02~0.02;P=0.88)。结论:针刺治疗PO在提高骨密度、减轻疼痛方面具有良好疗效,且安全性较高。但由于纳入文献质量偏低,大样本、高质量的临床研究亟待开展。
Objective： This study was intended to evaluate the efficacy and safety of acupuncture on primary osteoporosis （PO）. Methods：A systematic review was conducted of clinical trials compared acupuncture or acupuncture combining with conventional medicine to conventional medicine. Randomized controlled trials （RCTs） of clinical therapeutic studies on PO by acupuncture involving body acupuncture, abdomen acupuncture and electroacupuncture. Searches were applied to the following electronic databases ： PubMed, Cochrane Library, Web of Science, EMBASE, China National Knowledge Infrastructure （ CNKI）, Chinese Biomedical Literature Database （CBM）, VIP Database （VIP）, Wangfang Database, Chinese Clinical Trial Registration （ChiCTR）. Neither the publication status nor the language was restricted. All trials included were analyzed according to the Modified Jadad Score Scale. Review Manager 5.3 software was used for data analysis. Results ： 17 RCTs enrolling 1369 patients were included. Mean age of patients was 63.32,the follow - up duration ranged from20 days to 9 months. Compared to medicine treatment, acupuncture showed higher effectiveness （ OR = 3.21 ;95 % CI： 1.99 ~ 5.18 ;P 〈 0. 00001 ） and a statistically reduction in pain intensity （MD = -0.75;95% CI： - 1.17 ~ -0. 32;P =0. 0005） ,but no statistically significant improvement in BMD of lumbar （ biD = O. 03 ;95% CI： - 0.00 ~ 0. 07 ; P = 0. 08 ）. Compared to medicine treatment, acupuncture combing with conventional medicine showed higher effectiveness （ OR = 3.92 ;95% CI：2.43 ~ 6.31 ;P 〈 0. 00001 ）, a statistically reduction in pain intensity （ MD = - 1.71 ;95% CI ： - 2.22 ~ - 1.20 ;P 〈 0. 00001 ） and a statistically improvement in lumbar BMD （ MD = 0.09 ; 95% CI：0.08 ~ 0. 11 ;P 〈 0. 00001 ） ,but showed no no significant difference in bosting BMD of femur （MD = 0. 00 ;95% CI： - 0.02 ~ 0.02 ; P = 0. 88）. Conclusion： Acupuncture may have a favorable effect combating PO in boosting BMD and reducing pain intensity. Additionally, the adverse reaction rate of acupuncture is relatively low ,which makes it promising treatment. However, due to the low quality of the included studies, high quality studies are needed to provide the clear evidence for the future use of acupuncture.
出处
《辽宁中医杂志》
CAS
北大核心
2016年第12期2465-2471,共7页
Liaoning Journal of Traditional Chinese Medicine
基金
国家自然科学基金(81473692)
