针灸治疗老年性痴呆临床随机对照试验方法学评价

Methodological Evaluation of Randomized Controlled Trials for AD and VD Treated by Acupuncture and Moxibustion from Chinese Medical Literatures

目的 :评价国内针灸治疗老年性痴呆临床随机对照试验 (RCT)的质量 ,为改进和提高临床治疗水平提供依据。方法 :依据中国医学生物资料库 (CMB)中“针灸”与“痴呆”的结合主题词查找到 65篇文章 ;手工检索了 7种中医核心杂志 1990～ 1998年间所发表的文章 ,检索到 9篇文章 ;从已查找到的文章的参考文献处查到 6篇文章。依据防治性研究的临床对照试验原则 ,查找到符合RCT标准的文章 19篇 ,进行分析评价。结果 :近年发表的针灸治疗老年性痴呆RCT共计 19篇 ,占所有针灸研究痴呆文章的 2 5 %。其中 15篇有明确的诊断纳入标准 ,4篇有明确的排除标准 ;4篇论文中描述了具体的随机分组方法 ;8篇文章描述有组间可比性的统计学分析 ;无一篇述及盲法的运用 ;临床疗效判定均以各种积分量表评定 ,以总有效率表示 ;结果均作统计学处理 ,处理方法主要是t检验。结论 :近年来老年性痴呆的针灸RCT数量不断增加 ,但RCT质量需待提高 ,应努力提倡有资金资助的大样本前瞻性的长期的协作性研究。

Objective:To assess the quality of randomized controlled trials(RCTs)relevant to acupuncture and moxibustion in the treatment of dementia from Chinese medical journals to provide scientific basis with the hope to improve clinical works.Method:Sixty-five trials were searched from CMB;Seven traditional Chinese mdical core journals from the years of 1990 to 1998 were handsearched and 9 trials were identified;other 6 trials were identified from the references.Ninereen RCTs were identified in all.Result:The quantity and quality of these studies were far from satisfaction,they could not meet the clinical need.Conclusion:Improving the quality of RCT design and further testify the curative effect of senile dementia treated by Acupuncture and Moxibustion were neecled.