针灸治疗带状疱疹及其后遗症的系统评价再评价

Acupuncture Treatment of Herpes Zoster And Postherpetic Neuralgia:An Overview of Systematic Reviews

目的根据当今针灸治疗带状疱疹(HZ)及其后遗症的meta分析/系统评价(MA/SR),将其方法学及证据质量进行评价,以期为针灸治疗带状疱疹及其后遗症提供临床依据。方法对中国知网(CNKI),万方(Wanfang)和维普(VIP)数据库,中国生物医学文献数据库(CBM),PubMed,Embase,Cochrane Library,Web of Science 8个数据库进行检索,收集有关针灸治疗带状疱疹及其后遗症的MAs/SRs,运用AMSTAR对MAs/SRs进行方法学质量评价,同时采用GRADE系统对证据质量进行评价分级。结果本文共纳入20篇MAs/SRs,主要结论为针灸治疗HZ及其后遗症具有有效性和安全性。根据AMSTAR显示,20篇MAs/SRs中,有1个高质量研究,19个中等质量研究,无低等质量研究。GRADE评级显示,针灸对于带状疱疹及其后遗症的MAs/SRs具有较低的证据质量。所有结局指标中共有26个结局指标为极低质量,19个为低质量,11个为中等质量,无高质量的证据。结论当前MAs/SRs显示,针灸对带状疱疹及其后遗症具有一定疗效和安全性,方法学质量属于中高级,但证据质量级别属于低级,其主要原因为原始研究质量不佳所致。

Objective Based on the current systematic evaluation of acupuncture and moxibustion in the treatment of herpes zoster and its sequelae,the methodology and evidence quality were evaluated,so as to provide accurate clinical decisions for acupuncture and moxibustion in the treatment of herpes zoster and its sequelae.Methods In the database of CNKI,WanFang,VIP,CBM,Embase,PubMed and Cochrane Library,Web of Science,systematic review literatures on acupuncture treatment of HZ and PHN were searched,and the methodological quality of the literature was evaluated by AMSTAR list.Meanwhile,the GRADE system was used to grade the quality of evidence.Results A total of 20 systematic reviews were included,and the outcome was mainly due to the effectiveness and safety of acupuncture treatment of HZ and PHN.According to the AMSTAR score,there was one high quality study,19 moderate quality studies,and no low quality study.The GRADE showed that acupuncture had a relatively good quality of evidence for herpes zoster and its sequelae.A total of 26 outcomes were very low quality;19 were low quality,11 were of moderate quality evidence,and there was no high quality evidence.Conclusion Nowadays,acupuncture treatment of herpes zoster and its sequelae has certain efficacy and safety.The methodological quality is moderate to high,but the quality of evidence is low,mainly due to the poor quality of the original research.