针刺与西药治疗围绝经期综合征的疗效比较系统评价

Comparison System Evaluation on Acupuncture and Western Medicine Effect in the Treatment of Perimenopausal Syndrome

目的:与西药比较探讨针刺治疗围绝经期综合征的疗效的优势比较。方法:运用计算机网络检索中国生物医学文献数据库(1979~2015)、中国知网(1979~2015)、维普(1989~2015)和万方(1998~2015),并且手工检索江西中医药大学图书馆数据库。收集与西药比较针刺治疗PMS的RCT,由两名文献阅读者运用文献管理器Note Express 2.9.8各自阅读文献,依据纳入标准筛选文献,遵循Cochrane Review Handbook 4.2.8进行质量评价,并且运用Review Manager 5.3软件进行统计学分析。结果:共纳入40篇RCT,其中围绝经期综合征14篇,围绝经期干眼症1篇,围绝经期抑郁症13篇。Meta分析结果显示:共纳入40篇RCT,其中围绝经期干眼症1篇,围绝经期抑郁症6篇。Meta分析结果显示总有效率分析:针灸VS西药RR=1.12,95%CI[1.02,1.24],P<0.05,有统计学意义。针刺+西药VS西药OR=3.55,95%CI[1.87,6.73],P<0.05,有统计学意义。血清E2分析MD=5.59,95%CI[3.72,8.18],P<0.01,有统计学意义。FSH分析MD=-1.17,95%CI[-3.41,1.08],P>0.05,无统计学意义。LH分析MD=-0.40,95%CI[-1.66,-0.87],P>0.05,无统计学意义。MI分析MD=-3.52,95%CI-6.80,-0.24],P<0.05,有统计学意义。结论:针刺与西药治疗PMS,根据测量指标与标准的不同,研究结果存在差异,且针灸的不良反应少,但纳入文献质量不理想,需高质量的RCT来证实。

Objective： Comparative study on the therapeutic effect of acupuncture in treating climacteric syndrome with Western medicine.Methods：The use of computer network retrieval Chinese biomedical literature database （CBM） （1979～2015）, CNKI （1979～2015）,VIP（1989～2015） and WF（1998～2015）, and manual retrieval of library database in Jiangxi University of Traditional Chinese Medicine.Collection of acupuncture and Western medicine in the treatment of climacteric syndrome of RCT, by two literature reading through literature manager NoteExpress 2.9.8 their reading literature.According to the inclusion criteria selected literature, 4.2.8 quality evaluation according to the Cochrane Review Handbook, and on into the literature data results using Review Manager 5.3 software was used for statistical analysis.Results：40 RCT were included,perimenopausal syndrome 14,perimenopausal xerophthalmia 1, perimenopausal depression 13.The results of Meta analysis showed that 40 RCT were included in the perimenopausal xerophthalmia 1, perimenopausal depression 6.Meta analysis results show that： the total effective analysis： Acupuncture VS western medicine 95％CI[1.02,1.24], RR=1.12,P＜0.05, there was statistical significance.Acupuncture ＋ western medicine OR=3.55,95％CI[1.87,6.73],P＜0.05,VS, there was statistical significance.E2 analysis of serum MD=5.59, 95％CI[3.72,8.18],P＜0.01,there was statisticalsignificance.FSH analysis MD=-1.17, 95％CI[-3.41,1.08],P＞0.05, no statistical significance.LH analysis MD=-0.40,95％CI[-1.66,-0.87],P＞0.05, no statistical significance.MI analysis of MD=-3.52, 95％CI-6.80,-0.24,P＜0.05, have statistical significance.Conclusion： Acupuncture and Western medicine in treating perimenopausal syndrome according to the measurement indicators and criteria of different research results are different, and adverse effects of acupuncture and moxibustion less, but the inclusion of literature quality is not ideal and inseparable from the more high quality RCT to confirm.