针灸治疗抽动秽语综合征临床随机对照试验系统评价

Evaluation of Clinical Randomized Control Trials of Acupuncture for Treatment of Multiple Tics-coprolalia Syndrome

目的评价针灸治疗抽动秽语综合征的临床疗效,分析目前临床研究的现状。方法检索PubMed、Cochrane图书馆、CBM数据库、CNKI数据库等收集针灸治疗抽动秽语综合征临床随机对照试验,选择符合纳入标准的临床试验,以Co-chrane系统评价手册5.0进行质量评价,统计学分析采用RevMan4.2.8。结果 6篇文献符合纳入标准,共508例患者。Meta分析显示针灸治疗抽动秽语综合征对照常规药物临床症状改善有效率比较差异有统计学意义[合并OR(固定效应模型)=3.39,95%CI(1.73,6.65),Z=3.56,P=0.0004];YGTSS减分率有效率评价的OR=3.18,95%CI(1.00,10.07),P=0.05。结果显示两组差异没有统计学意义,即表明针灸治疗抽动秽语综合征在减低YGTSS减分率上没有优势;临床症状发作频度进步率有效率评分的RR=2.18,95%CI(0.54,8.75),P=0.27。结果显示两组差异没有统计学意义,即表明针灸治疗抽动秽语综合征在临床症状发作频度进步率评分上没有优势。结论针灸治疗抽动秽语综合征临床症状改善疗效优于常规西药;在YGTSS减分率、临床症状发作频度进步率评分尚未见明显治疗优势,但纳入样本量均较小、部分文献质量较低,结论尚不确定;尚需高质量研究进一步验证针灸治疗抽动秽语综合征的优势。

Objective To evaluate the clinical therapeutic effect of acupuncture for treating multiple tics-coprolalia syndrome,and to analyze the current situation of the clinical studies.Methods PubMed,Cochrane library,CBM database,CNKI database,etc were retrieved,the clinical randomized control trials of acupuncture for treating multiple tics-coprolalia syndrome were collected,the clinical trials in accordance with the inclusive criteria were selected,the quality evaluation was conducted with Cochrane systematic manual 5·0,and RevMan 4·2·8 was used for statistical analysis.Results 6 papers,which includes 508 patients,were in accordance with the inclusive criteria.Meta-analysis showed the difference of effective rate for clinical symptom improvement between acupuncture and routine medicine as control for treating multiple tics-coprolalia syndrome was significant [combined OR （odds ration）= 3.39,95%CI （0.54,8.75）,Z=3.56.P0·000 4].YGTSS effective rate evaluation：OR=3.18,95% CI（1.00,10.07）,P=0.05.The result showed that the difference between the two groups was not statistically significant,which means acupuncture for treating multiple tics-coprolalia syndrome has no advantages in the progressive rate evaluation of clinical symptom onset frequency.Conclusion Acupuncture had a better effect than the routine Western drug group on improving clinical symptoms of multiple tics-coprolalia syndrome.The YGTSS evaluation and the progressive rate evaluation of clinical symptom onset frequency showed no obvious therapeutic advantages.But because the inclusive sample amount was quite small,and the quality of some papers were not so good,so there’s still no definite conclusion.Further high quality studies are still needed to investigate the advantage of acupuncture for treating multiple tics-coprolalia syndrome.