摘要
目的系统评价针刺联合中药治疗强直性脊柱炎(ankylosing spondylitis,AS)的有效性和安全性。方法计算机检索中国知网(CNKI)、维普(VIP)、万方医学网(Wanfang)、中国生物医学文献数据库(CBM)、荷兰医学文献数据库(EmBase)、PubMed、Cochrane Library等数据库,检索时限从建库起至2022年10月11日,筛选出所有针刺联合中药治疗AS的中英文文献。筛选文献、提取数据后参照Cochrane风险偏倚评估工具进行文献质量评价,使用RevMan 5.3软件进行Meta分析。结果最终纳入10篇文献,910例AS患者,其中试验组458例,对照组452例。Meta分析结果显示,针刺联合中药治疗相比单纯西药治疗能进一步提高临床疗效(P<0.00001);显著降低红细胞沉降率(ESR)(P<0.00001)及超敏C-反应蛋白(CRP)(P=0.007);明显改善胸廓活动度(P<0.00001);降低晨僵时间(P<0.00001);并且安全性较好(P<0.00001);在改善Bath强直性脊柱炎病情活动指数(BASDAI指数)(P=0.67)、Bath强直性脊柱炎功能指数(BASFI指数)(P=0.96)方面无统计学意义,但根据敏感性分析,结果须谨慎对待。结论当前证据表明,针刺联合中药治疗AS疗效确切且安全性较好,但由于受纳入研究数量和质量的限制,上述结论尚需开展更多大样本、高质量RCT予以验证。
Objective To systematically evaluate the effectiveness and safety of acupuncture combined with traditional Chinese medicine in the treatment of ankylosing spondylitis(AS).Methods Computer searches were conducted on databases such as CNKI,VIP,Wanfang Medical Network,CBM,EmBase,PubMed,Cochrane Library,etc.The search period was from the establishment of the database until October 11,2022.All Chinese and English literature on acupuncture combined with traditional Chinese medicine for the treatment of AS were screened.After screening literature and extracting data,the quality of the literature was evaluated using the Cochrane risk bias assessment tool,and meta-analysis was conducted using RevMan 5.3 software.Results The final results included 10 articles and 910 AS patients,including 458 in the experimental group and 452 in the control group.The meta-analysis results showed that acupuncture combined with traditional Chinese medicine treatment can further improve clinical efficacy compared to simple Western medicine treatment(P<0.00001);Significantly reduced erythrocyte sedimentation rate(ESR)(P<0.00001)and high-sensitivity C-reactive protein(CRP)(P=0.007);Significant improvement in chest mobility(P<0.00001);Reduce morning stiffness time(P<0.00001);And it has good safety(P<0.00001);There was no statistical significance in improving the Bath Ankylosing Spondylitis Disease Activity Index(BASDAI index)(P=0.67)and Bath Ankylosing Spondylitis Function Index(BASFI index)(P=0.96),but according to sensitivity analysis,the results should be treated with caution.Conclusion The current evidence suggests that acupuncture combined with traditional Chinese medicine is effective and safe in treating AS.However,due to limitations in the number and quality of included studies,more large-scale,high-quality randomized controlled trials are needed to validate the above conclusions.
作者
董佩
袁普卫
康武林
白元帅
王慧霞
高亚丽
王振凯
DONG Pei;YUAN Puwei;KANG Wulin;BAI Yuanshuai;Wang Huixia;Gao Yali;WANG Zhenkai(Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712000,China;Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712000,China)
出处
《陕西中医药大学学报》
2025年第1期90-99,共10页
Journal of Shaanxi University of Chinese Medicine
基金
陕西省中医药管理局“骨退行性疾病中西医结合防治“双链融合”中青年科研创新团队”(2022-SLRH-LJ-001)
陕西中医药大学学科建设创新团队(骨关节及脊椎退行性疾病中西医结合防治创新团队2019YL-02)
长安医学关中李氏骨伤学术流派传承工作室建设项目(陕中医药发[2018]40号)
陕西省骨退行性疾病中西医结合防治重点研究室建设项目(陕中医药发[2018]32号)。
关键词
针刺
中药
强直性脊柱炎
有效性
安全性
META分析
Acupuncture
Traditional Chinese medicine
Ankylosing spondylitis
Effectiveness
Security
Meta analysis
