摘要
目的:系统评价针刺联合人工泪液治疗干眼的临床疗效并探讨选穴规律。方法:计算机检索CNKI、VIP、WanFang、Sinomed(CBM)、PubMed、Embase、Cochrane Library中针刺联合人工泪液治疗干眼的临床随机对照试验,检索时间为建库至2019年2月20日,由2名研究者按照PRISMA流程图,独立对纳入文献进行质量评价及资料提取,采用Stata/SE 14.0软件进行Meta分析,Excel软件进行腧穴频数、归经统计。结果:共纳入13篇文献,合计842例患者。与人工泪液相比,针刺联合人工泪液可提高治疗总有效率[RR=1.33,95%CI(1.17,1.52),P=0],增加泪液分泌量(SchirmerⅠtest,SⅠT)[WMD=2.34,95%CI(1.46,3.21),P=0],延长泪膜破裂时间(BUT)[WMD=1.42,95%CI(0.84,2.00),P=0],此外,两组均未见明显不良反应。腧穴频数统计7次以上穴位有攒竹、太阳、睛明、四白、丝竹空及三阴交。归经频数统计前3位是足太阳膀胱经、足阳明胃经及经外奇穴。结论:针刺联合人工泪液治疗干眼在总有效率、改善眼表功能方面均优于单纯使用人工泪液,且安全性好,选穴多以眼周为主,四肢次之,躯干部较少,但是由于纳入研究质量偏低,尚需更多高质量的随机对照试验以进一步验证。
Objective:To systematically review the clinical efficacy of acupuncture combined with artificial tears in the treatment of dry eyes,and to explore the rules of acupoints selection.Methods:The clinical randomized controlled trials about acupuncture combined with artificial tears in treating dry eyes were searched in data-bases,including CNKI,VIP,WanFang,Sinomed(CBM),PubMed,Embase and Cochrane Library.The retrieving time limitation was from the establishment of the databases to February 20,2019.Literatures were screened independently by two researchers according to the PRISMA flow diagram,and the methodological quality of included studies was evaluated.Meta-analysis was performed using Stata/SE 14.0 software.The frequency of acupoints and meridians were calculated by using Excel software.Results:A total of 13 RCTs were included involving 842 patients.In terms of Meta-analysis,acupuncture combined with artificial tears could significantly improve the total effective rate compared to single artificial tears therapy[RR=1.33,95%CI(1.17,1.52),P=0],it could increase the amount of tear secretion(SchirmerⅠtest,SⅠT)[WMD=2.34,95%CI(1.46,3.21),P=0],it also could prolong tear break-up time(BUT)[WMD=1.42,95%CI(0.84,2.00),P=0].No significant adverse reactions were observed in either group.The frequency of acupoints counted more than 7 times were Cuanzhu(BL2),Taiyang(EX-HN5),Jingming(BL1),Sibai(ST2),Sizhukong(TE23)and Sanyinjiao(SP6).The points used frequently were from Bladder Meridian of Foot-Taiyang and Stomach Meridian of Foot-Yangming,as well as extra points.Conclusion:Acupuncture combined with artificial tears in treating dry eyes is superior to simple application of artificial tears in terms of total effective rate and ocular surface function,which is with a high safety.The majority of selected acupoints is mainly around eye area,followed by limbs and body trunk.However,due to the low quality of the included researches,more high-quality randomized controlled trials are needed for further validation.
作者
张超源
余燕灵
彭紫荆
郑文江
刘碧娥
唐纯志
徐联洋
张宏
ZHANG Chaoyuan;YU Yanling;PENG Zijing;ZHENG Wenjiang;LIU Bi’e;TANG Chunzhi;XU Lianyang;ZHANG Hong(Clinical Medical College of Acupuncture Moxibustion and Rehabilitation,Guangzhou University of Chinese Medicine, Guangzhou 510405, China;The First Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)
出处
《针灸临床杂志》
2020年第6期59-65,共7页
Journal of Clinical Acupuncture and Moxibustion
基金
广东省高水平大学建设项目,编号:AFD018161Z0204
广东省大学生创新创业训练计划项目,编号:S201910572082。
关键词
干眼
针刺
人工泪液
META分析
Dry eyes
Acupuncture
Artificial tears
Meta-analysis
