针灸治疗视神经萎缩随机对照临床试验的Meta分析

Meta analysis of acupuncture in the treatment of optic atrophy

目的:评价针灸疗法治疗视神经萎缩的有效性和安全性。方法:计算机检索PubMed,Embase,CochraneLibrary,中国生物医学文献数据库(CBM),中国知网(CNKI),维普数据库(VIP),万方数据库,查找应用针灸治疗视神经萎缩(OA)的随机对照研究(RCT),同时追索纳入文献的参考文献。检索时限均为从建库至2012年11月01日。对纳入的研究的质量进行严格评价和资料提取,对符合质量标准的RCT进行Meta分析。结果:共纳入13个RCT,合计1180眼。Meta分析结果显示:针灸组与对照组相比,在总有效率[OR=3.281,95%CI(2.517,4.278)]、视力改善率[OR=3.287,95%CI(2.193,4.925)]、视野改善率[OR=3.215,95%CI(1.580,6.543)]均有统计学差异;在视野敏感度改善、P-VEP潜伏期缩短和振幅增加方面,针灸组也显示出较对照组更优的趋势。结论:从现有的临床证据来看,针灸治疗OA有效,但文章纳入试验数有限且文献质量较低,需设计更严格的随机对照试验来进一步验证。

Objective： To evaluate the efficacy and safety of acupuncture for optic atrophy. Methods： All the randomized controlled trials （RCTs） on optic atrophy treatment with acupuncture were included after retrieving the PubMed, Embase, Cochrane Library, CBM, CNKI, VIP, Wanfang database from their establishment to November 2012. The bibliographies of the included studies were retrieved as well. The quality of RCTs meeting the inclusion criteria was evaluated and the data were extracted. Meta-analyses were performed with Stata 11.2 software. Results： Thirteen RCTs involving 1180 eyes were included. Meta-analyses showed that the effect of acupuncture or combined with medicine was superior to medicine alone in terms of total effectiveness [OR=3.281, 95% CI （ 2.517, 4.278）], visual acuity [3.287, 95% CI （2.193, 4.925）], and visual field[3.215, 95% CI （1.580, 6.543）]. q-he visual sensitivity and P-VEP test showed the similar results. Conclusion： Acupuncture is superior to medicine in terms of improved visual acuity, visual field and P-VEP. However, large samples, and high-quality studies are needed for stronger evidence.