针灸治疗臀先露的系统评价

Acupuncture and Moxibustion for Breech Presentation:A Systematic Review

目的系统评价针灸治疗臀先露的疗效。方法计算机检索Cochrane Library(Issue1,2008)、PubMed(1980～2008.3)、MEDLINE(1966～2008)、Ovid循证医学数据库(1991～2008),中国生物医学文献数据库(CBMdisc,1978～2008.3)、维普期刊全文数据库(VIP,1989～2008.3)、中国期刊全文数据库(CNKI,1979～2008.3)和万方数据资源系统(1983～2008.3),手工检索7种中医杂志,检索时限均为1990～2008年3月,语种限制为中文和英文,按纳入排除标准收集针灸治疗臀先露的随机对照试验(RCT),参照Cochrane系统评价员手册5.0.1推荐的对偏倚风险的评价工具进行文献质量评价,并采用RevMan5.0软件进行Meta分析。结果最终纳入8个RCT,共1341例患者,其中5个研究质量较高,3个质量较低。6个研究的Meta分析结果显示,针灸治疗臀先露的胎头倒转成功率优于对照组,差异有统计学意义[RR=1.38,95%CI(1.20,1.58)]。结论针灸较之于常规护理或胸膝卧位疗法能提高臀先露的胎头倒转成功率。

Objective To evaluate the efficacy of acupuncture and moxibustion （acup-moxi） therapy for breech presentation. Methods We electronically searched The Cochrane Library （Issue 1, 2008）, PubMed （1980 to Mar. 2008）, MEDLINE （1966 to 2008）, Ovid EBM Database （1991 to 2008）, CBMdisc （1978 to Mar. 2008）, VIP （1989 to Mar. 2008）, CNKI （1979 to Mar. 2008）, and WangFang Database （1983 to Mar. 2008）, as well as handsearched seven traditional Chinese medicine journals to obtain randomized control trials （RCTs） about acup-moxi for breech presentation. Quality assessment was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions 5.0.1. Metaanalyses were performed for the results of homogeneous studies using RevMan 5.0 software. Results Eight RCTs involving 1 341 patients met the inclusion criteria. Five trials were of relatively high quality and 3 were of low quality. The pooled analysis of six trials showed that acup-moxi was superior in cephalic presentation with RR=1.38, and 95%CI 1.20 to 1.58. Conclusion Acup-moxi can increase the successful rate of cephalic presentation in the treatment of breech presentation compared with no （routine care） or knee-chest position treatment.