皮肤病症循证等级针灸病谱研究

Study on Evidence-based Disease Spectrum of Acupuncture-Moxibustion on Skin and Subcutaneous Tissue System

目的评价针灸治疗皮肤病症的临床疗效,为皮肤病症循证等级针灸病谱的划分提供客观依据。方法以PubMed、Ovid、Cochrance图书馆、EMBase、中国生物医学文献数据库、中国知网、维普全文期刊数据库、万方数据库等为检索源,全面收集针灸治疗皮肤病症临床试验文献,对符合纳入标准的文献进行Meta-分析,评价效应量并根据证据等级划分针灸病谱等级。结果获得针灸治疗皮肤病症临床试验中文文献1149篇、英文文献3篇,其中随机对照试验文献224篇,符合纳入标准随机对照试验56项,共涉及11种皮肤病症;依据效应量分析结果及文献质量情况,得到强证据4项、中证据10项、弱证据15项。结论初步获得皮肤病症循证等级针灸病谱为,肯定有效病谱:痤疮(囊肿型)、慢性荨麻疹、神经性皮炎(局限性);很可能有效病谱:黄褐斑、鸡眼、皮肤瘙痒症;可能有效病谱:斑秃、湿疹、银屑病、白癜风、褥疮。

Objective To evaluate the therapeutic effect of acupuncture-moxibustion for treatment of disease of skin and subcutaneous tissue and to provide objective evidence for classifying the evidence-based disease spectrum of acupuncture-moxibustion. Methods Retrieve PubMed,Cochrane Library,Ovid,EMBase,CBM,CNKI,WANFANG,VIP,and collect the randomized controlled trials of treatment of disease of skin and subcutaneous tissue with acupuncture and moxibustion,select those conforming with the enrolled criteria,and use Meta-analysis to evaluate the effect and grade the disease spectrum of acupuncture and moxibustion according to the evidence degree. Results Totally 1149 clinical studies in Chinese and 3 full text papers in English were acquired. Of them,there were 224 randomized controlled trials,and 56 studies conformed to the enrolled criteria,with 11 diseases involved. Based on the result of Meta-analysis and the quality of studies,4 studies of strong-evidence,10 of moderate-evidence,and 15 of weak-evidence were obtained. Conclusion Based on the present evidences,the effect of acupuncture-moxibustion is definitely beneficial in acne （cystic type）,chronic urticaria,and neurodermatitis （localized）; the effect of acupuncture-moxibustion is likely to be beneficial in chloasma,clavus,and pruritus; and the effect of acupuncture-moxibustion is possibly beneficial in alopecia areata,eczema,psoriasis,vitiligo,and bedsore.