针灸与西药治疗前列腺增生症疗效比较的系统评价

Acupuncture and moxibustion versus western medicine for benign prostatic hyperplasia:a systematic review

目的:评价目前针灸治疗前列腺增生症相关文献的质量以及针灸与西药比较治疗前列腺增生症的临床疗效及其安全性。方法:检索PUBMED、Cohrance图书馆、CBM数据库、CNKI数据库等收集针灸与西药比较治疗前列腺增生症的临床随机或半随机对照试验,选择符合纳入标准的临床试验并由两名评价者独立进行数据的提取。以Cochrane系统评价手册4.2.6进行质量评价,统计学分析采用RevMan4.2.8。结果:共纳入6个随机或半随机对照试验(共546例)。6项研究采用总有效率为评价指标,Meta-分析显示针灸治疗前列腺增生症对照西药,组间比较差异有统计学意义[合并RR(固定效应模型)=1.26,95%CI(1.15,1.37),Z=5.13,P<0.00001]。3项研究采用治愈率为评价指标,Meta-分析显示针灸治疗前列腺增生症对照西药,组间比较差异有统计学意义[合并RR(固定效应模型)=4.53,95%CI(2.16,9.50),Z=4.00,P<0.0001]。结论:针灸治疗前列腺增生症安全、有效,对照西药可能有一定优势,但因纳入文献数量有限且质量较低,结论尚不确定,需高质量随机双盲对照试验来进一步验证。

Objective：To evaluate the quality of prostate hyperplasia related literature in acupuncture and moxibustion,and to compare the curative effect on prostate hyperplasia between acupuncture and moxibustion and western medicine.Methods：Retrieving Pubmed,Cochrane Library,CBM database,CNKI database Etc.to collect the literature of prostate hyperplasia of clinical randomized or quasi-randomized control trials of comparative study between western medicine and acupuncture treatment.The data was extracted independently by two valuers from literatures fitting the selection criteria.Cochrane evaluation manual 4.2.6 was used to evaluate quality,and RevMan 4.2.8 was used in statistical analysis.Results：A total of six randomized or quasi-randomized controlled trials （total 546 examples） were adopted.6 study adopted the total effective rate of evaluation indexes,Meta-analysis showed that there was a significant difference between acupuncture treatment group and western medicine group [merger RR （fixed effects model）=1.26,95%CI（1.15,1.37）,Z=5.13,P〈0.00001].3 studies using cure rate for evaluation,Meta-analysis showed that there was a significant difference between acupuncture treatment group and western medicine group [merger RR（fixed effects model）=4.53,95%CI（2.16,9.50）,Z=4.00,P〈0.0001].Conclusion：Acupuncture treatment of prostate hyperplasia was safe and effective,there was probably a great advantage compared with western medicine.But because of the limited quality and low quantity of literature,the conclusion was uncertain,it needed further verification by high quality of a double-blind randomized controlled trial.