国内针灸治疗原发性痛经的系统评价

Systematic Review of Acupuncture Treatment of Primary Dysmenorrhea

目的:评价国内针灸治疗原发性痛经(PD)的临床疗效,分析当前研究状况。方法:搜集相关随机对照试验文献,筛选合格研究共28项,并对其应用评分标准进行质量评价,运用Meta-分析,漏斗图分析等方法统计相关数据,得出综合结论。结果:24篇文献评分在3分以下,文献质量一般;Meta-分析合并OR=6.82,95%可信区间为5.20～8.94,菱形位于垂线右侧(Z=13.89,P<0.00001),表明针灸对PD的治疗效果治疗组疗效优于对照组,差异有极显著性意义;漏斗图左右不对称,呈偏态分布,提示可能存在发表性偏倚。结论:单纯从统计结果分析,可认为针灸治疗本病疗效基本肯定,但研究质量低是影响该系统评价结论的最主要因素。因此,应用上述结论应谨慎。而要证实其疗效及安全性,尚需要严格设计、执行严格、多中心大样本且随访时间足够的随机对照试验。

Objective：To evaluate the clinical efficacy of acupuncture treatment of primary dysmenorrhea（PD） and analyze the current research status. Methods ：28 randomized controlled trials were used for application of standard quality evaluation. Meta - analysis, funnel plot analysis and other methods of statistical data were used for a comprehensive conclusion. Results：There were 24 papers below 3 with general quality; Meta -analysis combined with OR = 6.82, 95% confidence in- terval 5.20 -8.94, diamond in vertical right （Z = 13.89 ,P 〈0.00001 ）, it showed that the control effect of acupuncture and moxibustion on PD in treatment group had significant meaning; funnel plot showed a skewed distribution, suggesting the possible presence of publication bias. Conclusion： Results from the statistical analysis, acupuncture treatment of this disease is basically affirmed, but the research of low quality is the main factor that influences the system evaluation conclusion. Therefore, application of these conclusions should be cautious. To confirm its efficacy and safety, it need randomized controlled trials of strict design and implementation with multicenter large sample and enough follow - up time.