穴位埋线治疗变应性鼻炎有效性和安全性系统评价

Catgut Implantation at Acupoints for Allergic Rhinitis:A Systematic Review

目的:系统评价穴位埋线治疗变应性鼻炎的有效性和安全性。方法:计算机检索PubMed、The Cochrane Library、CBM、CNKI和WanFang Data数据库,检索时限为从建刊至2016年9月,检索穴位埋线治疗变应性鼻炎的相关随机对照实验(RCT)。由两位研究人员按纳入与排除标准独立进行文献筛选、资料提取及纳入研究的质量评价后,采用RevMan 5.3软件进行Meta分析。结果:共纳入8篇RCT,共计624例患者。Meta分析结果示:(1)症状评分改善总有效率:穴位埋线组优于非穴位埋线组[RR=1.15,95%CI(1.05,1.27),P<0.05]、西药组[RR=1.11,95%CI(1.00,1.24),P>0.05]、穴位敷贴组[RR=1.28,95%CI(1.11,1.48),P<0.05],但仅与非穴位埋线组、穴位敷贴组的比较差异有统计学意义(P<0.05);(2)不良事件发生率:本次纳入的8篇文章中仅4篇提及,Meta分析结果示:RR=0.33,95%CI(0.36,2.83),穴位埋线组不良事件发生率低于非穴位埋线组,但95%CI经过等效线,故两者不良事件发生率差异无统计学意义(P>0.05)。结论:穴位埋线能改善变应性鼻炎患者的症状,且无明显不良反应。受纳入研究数量和质量的限制,上述结论仍需开展更多高质量、大样本的RCT进行验证。

Objective：Objective：To systematically review the efficacy and safety of Catgut implantation at acupoints for allergic rhinitis. Methods：We searched PubMed,The Cochrane Library,CBM, CNKI, WanFang Data databases from inception to Sept. 30th 2016, to collect randomized controlled trials （RCTs） on Catgut implantation at acupoints for Allergic rhinitis. Two reviewer independently screened literature, extracted data, and assess the risk of bias of included studies. Then, meta-analysis was conducted by using RevMan 5.3 software. Results：A total of 8 RCTs involving 624 patients were included. The results of meta-analysis showed that：（1） As for the total effective rate, Catgut implantation group was superior than non acupoint catgut embedding group [RR = 1.15, 95%CI （1.05, 1. 27）, P〈0.05], western medicine group [RR=1. 11, 95%CI （1, 1.24）, P〉0. 05], acupoint application group [RR： 1.28, 95% CI （1.11, 1.48）, P〈0.05] ;（2） The incidence of adverse events： the 8 articles included in only 4 articles, Meta analysis showed that catgut implantation group the incidence of adverse events was lower than that of non aeupoint catgut embedding group[RR=0.33, 95%CI （0.36, 2.83）, P〉0.05] . Conclusion：It is suggested that Catgut implantation at acupoints is an effective treatment for allergic rhinitis and there is no severe side effect. Due to the limited quantity and quality of the included studies, the above conclusion needs to be further verified by more high quality RCTs.