灸法护理治疗恢复期顽固性面瘫临床疗效的系统评价

The system evaluation of clinical efficacy of the moxibustion for intractable facial paralysis during convalescence

目的:基于循证医学理论,对灸法护理治疗恢复期顽固性面瘫的临床疗效进行系统评价,以期为顽固性面瘫的灸法治疗提供有力的支持依据。方法:计算机检索2018年9月1日前PubMed、Embase、中国知网(CNKI)、中国生物医学文献数据库(CMB)、维普(VIP)和万方数据库等全文数据库,纳入灸法治疗顽固性面瘫的随机和半随机对照试验文章,运用Review Manager 5.3软件对纳入文献的研究方法学进行质量评价及偏倚风险评估,同时对主要结局指标有效率及次要结局指标HouseBrackmann面神经功能评级进行系统评价。结果:共纳入13项研究,累计样本量1128例。结果显示:试验组的有效率高于对照组,异质性检验χ~2=35.52,P=0.005,I^2=66%,异质性较大,选用随机效应模型。合并效应值RR=1.10,95%CI[1.03,1.17],合并效应量检验Z=2.84,差异具有统计学意义(P=0.005)。试验组改善面神经功能及面部活动程度优于对照组,House-Brackmann分级值MD=-0.96,95%CI[-1.05,-0.86],Z=19.05,P<0.00001,差异有统计学意义。结论:灸法护理治疗恢复期顽固性面瘫具有更好的临床疗效,值得推广应用。但鉴于本次研究纳入研究文献较少,质量较低,仍需更多高质量的临床研究加以验证。

Objective: To systematically evaluate the clinical effect of moxibustion on refractory facial paralysis in convalescent period based on the theory of evidence-based medicine,so as to provide a strong basis for the treatment of refractory facial paralysis by moxibustion.Methods: Computer retrieval of full-text database such as PubMed,Embase,CNKI,CMB,VIP and WanFang DATA,which deadline was September 1,2018.The randomized and semi-randomized controlled trials of moxibustion for refractory facial paralysis were included.Review Manager 5.3 software was used to conduct quality evaluation and bias risk assessment of the included literature research methodology,and the efficiency of the main outcome indicators and the secondary outcome indicators of House-Brackmann facial nerve function rating were systematically evaluated.Results: A total of 13 studies were included,with a total sample size of 1128 cases.The results showed that the treatment group had higher efficiency than the control group,and heterogeneity test chi square =35.52,P=0.005,I^2=66%,heterogeneity is larger,and random effects model is adopted.Combined effect value RR=1.10,95%CI[1.03,1.17],Z=2.84,and the difference was statistically significant(P=0.005).Conclusion: Moxibustion as an adjuvant therapy for intractable facial paralysis in convalescence has better clinical effects and is worthy of popularization and application.However,due to the lack of literature and low quality,more high-quality clinical studies are needed to verify this study.