针刺与西药比较预防性治疗偏头痛的Meta分析

Meta-Analysis on Prevention Comparison of Acupuncture with Western Medicine for Migraine

目的:系统评价针刺与西药比较预防性治疗偏头痛的疗效及安全性。方法:计算机检索Pubmed、Cochrane Library、Medline、CNKI、VIP、万方数据库,收集针刺与西药比较预防性治疗偏头痛的所有随机对照临床试验,按Cochrane系统评价的方法评价纳入研究质量并使用Rev Man 5.2软件对纳入研究进行Meta分析。结果:共纳入符合标准的文献18篇,总样本量1470例。Meta分析显示:针刺其近期疗效[RR=2.76,95%CI(2.03,3.77),P<0.00001]和远期疗效[RR=4.17[95%CI,2.80,6.20],P<0.00001]均明显优于西比灵(氟桂利嗪)、尼莫地平等西药;针刺与美托洛尔比较,其减少头痛次数疗效明显优于美托洛尔[RR=-0.79,95%CI(-1.39,-0.20),P=0.009]。结论:针刺预防性治疗偏头痛有效,其近期疗效、远期疗效、减少头痛次数疗效均优于西药,并且针刺预防性治疗偏头痛有安全性高、不良反应少的特点。由于本研究纳入研究的例数较少且方法学质量较低,因此文章结论有待更多设计合、执行严格的多中心大样本的随机对照试验来验证其疗效及安全性。

Objective： To evaluate the efficacy comparison of acupuncture and western medicine for migraine. Methods： We searched the Cochrane Library,Pub Med,Medline,CNKI,VIP and Wan Fang to identify the randomized controlled trials comparing acupuncture with western medicine for migraine. The quality of included studies was critically assessed and the data analysis was performed with The Cochrane Collaboration＇ s Rev Man5. 2. Results： Eighteen studies were included. The Meta-analysis showed in treating migraine,the short-term response rate[RR = 2. 76,95% CI（ 2. 03,3. 77）,P〈0. 00001]and the long-term response rate [RR = 4. 17,95% CI（ 2. 80,6. 20）,P〈0. 00001] of acupuncture was significant better than that of western medicine. It also showed that acupuncture was significantly better than Metoprolol in reducing migraine times[RR =-0. 79,95% CI（-1. 39,-0. 20）,P = 0. 009]. Conclusion： The short and long-term effectiveness of acupuncture is significant better than that of western medicine in migraine treatment. However,due to the poor quality and small sample of the included trials,more large-scale multi-center randomized trails are needed.