摘要
【目的】运用循证医学的方法 ,对醒脑开窍针法治疗中风的临床疗效及安全性进行系统评价和Meta分析。【方法】全面收集醒脑开窍针法治疗中风的临床试验资料 ,在严格质量评价的基础上 ,利用RevMan 4 1软件对多个研究结果的总体效应进行随机效应模型的Meta分析 ,并进行分层分析、异质性评价和敏感性分析 ;用漏斗图分析发表性偏倚。【结果】醒脑开窍针法治疗 (痊显率 )效应值OR =3 6 5 ,95 %可信区间为〔1 70 ,7 83〕 ;降低远期病死率效应值OR =0 2 1,95 %可信区间为〔0 0 8,0 5 2〕 ;分层分析结果显示 ,中风后遗症期治疗效应值OR =4 0 1,脑梗塞治疗效应值OR =4 4 5 ;漏斗图图形不对称 ;本研究所纳入的文献均未发现不良反应的报道。【结论】醒脑开窍针法治疗中风有一定疗效 ,对脑梗塞、尤其是脑梗塞急性期有较确切的疗效 ,并可降低中风患者的远期病死率。通过异质性评价与敏感性分析发现异质性的原因可能是试验设计类型不同和纳入标准不同。漏斗图提示存在发表性偏倚。现有的研究结论尚有一定局限性 ,欲得出公认的结论 ,还有待进行多中心、随机对照的临床试验。
Based on the principle of evidence-based medicine, the efficacy and safety of consciousness-restoring and orifice-opening (CROO) acupuncture manipulation in treating stroke are systematically assessed. All reports of clinical trials of CROO acupuncture manipulation in treating stroke were collected and random-effect model of Meta-analysis was performed by using the statistical software of Review Manager (RevMan4.1). Sensitivity and heterogeneity were analyzed and tested; funnel-plot analysis was used to identify the publication bias. Comprehensive efficacy (Odds Ratio, OR) of CROO acupuncture manipulation in treating stroke was: OR of cure and markedly effective rate between groups being 3.65 and 95% confidence interval (CI) in the range of 1.70～7.83, OR for decreasing long-term death rate being 0.21 and 95% CI in the range of 0.08～0.52. Stratified analysis showed that OR of stroke sequela was 4.01 and OR of cerebral vascular infarction was 4.45. Adverse drug reaction was not found in all of the reports. Funnel-plot analysis showed the possible existence of publication bias. [ Conclusion]CROO acupuncture manipulation has certain effect in treating stroke, especially in treating acute stage of cerebral vascular infarction, and could reduce long-term death rate of stroke. Heterogeneity may result from the difference of trial designs and inclusive criteria. Funnel-plot analysis shows the possible existence of publication bias. This conclusion is rather limited and will get more evidence if multi-center, double-blinded, randomized and controlled trials could be carried out.
出处
《广州中医药大学学报》
CAS
2004年第3期215-219,共5页
Journal of Guangzhou University of Traditional Chinese Medicine
关键词
醒脑开窍针法
中风
META分析
循证医学
中医
STROKE/acup-mox therapy
CONSCIOUSNESS-RESTORING AND ORIFICE-OPENING
EVIDENCE-BASED MEDICINE
META ANALYSIS
