针刺治疗乳腺结构不良的临床疗效和安全性评价

Acupuncture for Mammary Dysplasia: A Systematic Review

目的评价各种针刺方法治疗乳腺结构不良的有效性和安全性。方法通过电子和手工检索两种方式,对Cochrane图书馆、CENTRAL、MEDLINE(1996～2004)、EMBASE(1980～2004)、中国生物医学文献数据库(1975～2004)、中国期刊全文数据库(1994～2004)等中英文数据库、相关学术会议论文汇编及文章的参考文献进行检索,纳入评价针刺或针刺合并其他疗法治疗乳腺结构不良临床疗效的随机对照试验和半随机对照试验。结果共5篇文献符合纳入标准,其例数从78例到180例不等,共计534例。1个研究内的两个亚组的痊愈率比较提示,针刺与乳癖消治疗乳腺结构不良的痊愈率差异有统计学意义[RR9.00,95%CI(2.29,35.43);RR8.04,95%CI(2.20,32.02)],且疗效优于乳癖消;6个显效率(包括亚组分析)的组间比较均提示,针刺与其他疗法的组间差异无统计学意义。所有研究均未报道不良事件的发生情况。结论由于纳入证据的质量太低和数量太少,针刺治疗乳腺结构不良的疗效尚不肯定,其有效性和安全性尚需更多高质量的RCT来验证。

Objective To assess the effectiveness and safety of various types of acupuncture in the treatment of mammary dysplasia. Methods We searched The Cochrane Library, CENTRAL, MEDLINE(19662004), EMBASE(19802004), CBM(19752004), CNKI(19972004) and reference lists, databases of ongoing trials and relevent academic conference proceedings. Results Five studies involving 534 women ranging from 78 to 180 met the inclusion criteria. The recovery rates of two groups in one study showed acupuncture was statistically superior to Rupixiao (RR 9.00, 95%CI 2.29 to 35.43; RR 8.04, 95%CI 2.20 to 32.02), six good improvement rates (including groups analysis) indicated that there was no significant difference between acupuncture and other therapies. None of the studies reported incidence of adverse reaction. Conclusions Overall, there is no conclusive evidence for acupuncture in the treatment of mammary dysplasia because the quality of included studies and amount of evidence are both poor and insufficient. There is an urgent need for larger, well-designed randomised controlled trials to assess the effectiveness and adverse-effect of acupuncture.