针灸治疗痤疮随机对照临床研究文献的Meta分析

Meta-analysis of Clinical Randomized and Controlled Trials of Treatment of Acne with Acupuncture and Moxibustion

目的:对针灸治疗痤疮的疗效和安全性进行系统综合分析,为针灸治疗痤疮提供更有力的证据。方法:计算机检索CNKI、WANFANG、VIP、CBM、Pub Med和Medline数据库中公开发表的针灸治疗痤疮的RCTs和/或半随机对照试验(CCTs)。年限:2001年1月至2014年3月,由2名研究人员独立检索,筛选文献,并独立对纳入文献依据Cochrane系统评价方法学进行数据提取和质量评价。用Rev Man 5.2软件进行Meta分析。结果:共纳入28项研究,研究对象2409例,其中针灸组1279例,对照组1130例。28项研究均以疗效作为主要结局指标,Meta分析结果显示,针灸组与对照组比较,在总有效率[OR=4.40,95%CI(3.38,5.73)]、血清睾酮变化[OR=-0.84,95%CI(-1.09,-0.59)]、皮损积分[OR=-0.29,95%CI(-0.51,-0.07)]方面,差异均有统计学意义(P<0.05)。结论:针灸治疗痤疮与西药相比具有一定的优势,但其结论仍需更多高质量、低风险的随机对照文献来验证支持。

Objective： To comprehensively analyze the system efficacy and safety of acupuncture in the treatment of acne, and to provide powerful evidences for chnical treatment. Method： This thesis would utilize data from the CBM, CNKI, VIP, WANFANG, Pubmed, Medline, from January 2001 to March 2014, with the randomized controlled clinical trials on acupuncture treatment of acne. The selection of studies, assessment of methodological quality and data extraction were performed indepen- dently by two researchers. The methodological quality was assessed by the Cochrane system evaluation methodology, and then give a meta analysis of the result by the soft Revman 5.2. Results： A total of 28 studies, involving 2409 patients （1279 in treatment group, 1130 in control group） were indentified. The 28 papers all adopted the cure rate as the evaluation index, Meta-analysis showed that the effects of acupuncture and moxibustion was superior to western medicine in terms of total effec- tiveness[OR=4.40, 95%CI（3.38, 5.73）], serum testosterone changes [OR=-0.84, 95%CI（-1.09, -0.59）] and skin lesion score[OR=- 0.29, 95%CI（-0.51, -0.07）]. Conclusions： The effects of acupuncture and moxibustion is superior to western medicine in treat- ment of ache, but it still need more high-quality, low-risk randomized controlled trials to verify support.