热敏灸治疗周围性面瘫随机/半随机对照试验的Meta分析

Meta Analysis on Clinical Randomized/Semi-randomized Controlled Trials of Heat-sensitive Moxibustion for Peripheral Facial Paralysis

目的:系统评价热敏灸治疗周围性面瘫的临床疗效,为临床治疗及开展相关研究提供参考和帮助。方法:计算机检索Pub Med、Springer、中国生物医学文献数据库(CBMdisc)、中国知网(CNKI)、维普数据库(VIP)、万方数据库,文献检索起止时间均从建库到2015年1月,纳入热敏灸治疗周围性面瘫的临床随机/半随机对照试验文献,试验数据用Revman5.2软件进行Meta分析。结果:共检索到随机/半随机对照试验12个,1039例患者纳入本次研究。12个试验均以有效率作为结局指标,显示热敏灸组与对照组比较,合并后RD=0.07,95%CI[0.03,0.10]。总体效应检验,Z=3.76,P<0.01,两组在治疗周围性面瘫方面疗效比较,差异有统计学意义(P<0.01)。亚组分析:热敏灸组VS常规针刺组,合并后RD=0.06,95%CI[0.02,0.10]。总体效应检验,Z=2.78,P<0.01,两组在治疗周围性面瘫方面疗效比较,差异有统计学意义(P<0.01)。结论:热敏灸组治疗周围性面瘫临床疗效优于对照组。同时,热敏灸具有无痛苦、患者接受度高、操作简单的优势,建议临床医生根据实际情况选择热敏灸综合治疗周围性面瘫。可靠结论尚需大样本、多中心、设计良好的随机对照试验来进一步验证。

Objective： To systemically analyze the clinical therapeutic effect of heat-sensitive moxibustion on peripheral facial paralysis, and to provide reference and assistance for its clinical treatment and research. Methods： Conducting literature retrieval through the PubMed, Springer, China Biology -Medicine disc （CBMdisc）, China Hownet（CNKI）, Vip database （VIP） and Wanfang databases, and all the collected literature should be published between the establishing time of databases and January 2015; Integrating literature about the clinical randomized/semi-randomized controlled trials of heat-sensitive moxibustion for peripheral facial paralysis and applying Revman 5.2 for the meta-analysis of experimental data. Results： Totally 12 randomized/semi- randomized controlled trials were acquired with 1039 cases involved in the study. The effective rate was selected as primary outcome measure in the 12 trials. The Meta-analysis was performed among homogeneous researches. The results indicated that heat-sensitive moxibustion group compared with the control group,pooled RD of heat-sensitive moxibustion group was 0.07 with 95% CI [0.03, 0.10]. In the test for overall effect, implying the efficacy difference of two groups was significant in the treatment of peripheral facial paralysis （Z= 3.76, P〈0.01）. In subgroups analysis, heat-sensitive moxibustion group compared with the conventional acupuncture group,pooled RD of heat-sensitive moxibustion group was 0.06 with 95% CI [0.02, 0.10]. In the test for overall effect, implying the efficacy difference of two groups was significant in the treatment of peripheral facial paralysis （Z=2.78, P〈0.01）. Conclusions： The clinical efficacy of heat-sensitive moxibustion group is superior to the control group of peripheral facial paralysis. Meanwhile, the heat-sensitive moxibustion has some advantages： no pain, patients receiving high, simple operation. It is suggested that clinical doctors should choose cupoints ihermal moxibustion combined with other treatments for peripheral facial paralysis according to the actual situation. Reliable conclusions still need a large sample, multi-center, well-designed randomized controlled trials to further verification.