针灸治疗后遗症期周围性面瘫疗效的Meta分析

目的系统评价针灸治疗后遗症期周围性面瘫的疗效.方法计算机检索中国期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Web of science数据库,检索时限为建库至2022年3月14日,观察组以针灸治疗为主,对照组以西药治疗或空白对照或假针刺,以有效率、面部神经功能评价分级系统(House-Brackmann grade H-B)评级、BELL氏麻痹十项记分法评分为结局指标,采用RevMan 5.4软件进行Meta分析.结果共纳入2篇英文文献,8篇中文文献,613例患者.Meta分析结果显示,观察组总有效率优于对照组(OR=3.26,95%CI:2.12~5.02,P<0.001);观察组治疗后H-B评级为轻中度(1~3级)例数占比优于对照组(OR:3.90,95%CI:1.01~15.09,P=0.05);H-B评级比较观察组与对照组差异无统计学意义(WMD:-0.77,95%Cl:-1.90~0.36,P=0.18);Bell氏麻痹十项记分法评分比较观察组优于对照组(WMD:-2.33,95%Cl:-3.25~-1.42,P<0.001).结论针灸治疗后遗症期周围性面瘫有较好的疗效,但缺乏更多高质量、大样本的随机对照试验和确切、统一的评价指标.

Objective To demonstrate the eficacy of acupuncture-moxibustion treated in sequelae stage of peripheral facial paralysis by metaanalysis.Methods CNKI,Wanfang,VIP,Sinomed,PubMed and Web of science were searched to collect the clinical trial literature of acupuncturemoxibustion treated in sequelae stage of peripheral facial paralysis.The retrieval time limit was from the establishment of the database to March 14th,2022.The included literature of observation group was treated with acupuncture-moxibustion,and the control group was treated with western medicine or no treatment.The effective rate,the rating of facial nerve function evaluation grading system(House-Brackmann grade H-B)and the Bll's ten scoring were used as the outcome indicators.RevMan 5.4 software was used for meta-analysis.Results A total of 2 English papers and 8 Chinese papers,and 613 cases were included.The results of meta-analysis showed that the effective rate of the observation group was better than that of the control group[OR=3.26,95%CI(2.12~5.02),P<0.001].After the treatment,the proportion of cases whose H-B Grade with mild to moderate(Grade 1~3)in the observation group was better than that in the control group(OR:3.90,95%CI:1.01~15.09,P=0.05).There was no statistical difference in H-B Grade between the observation group and the control group(WMD:-0.77,95%Cl:1.90~0.36,P=0.18).The Bells ten scoring in the observation group was better than that in the control group(WMD:-2.33,95%Cl:-3.25~-1.42,P<0.001).ConclusionAcupuncture and moxibustion have a good effect on peripheral facial paralysis in sequelae stage,but there is a lack of more high-quality,large sample randomized controlled trials and accurate and unified evaluation indicators.