针刺治疗干燥综合征临床疗效的Meta分析

Meta-analysis of Treating Sj?gren's Syndrome with Acupuncture

目的:探讨针刺治疗干燥综合征的临床疗效,为其临床实践提供循证医学证据。方法:运用计算机检索中国知网、维普、万方等数据库,收集针刺治疗干燥综合征的临床随机对照试验(RCT),检索时间为建库至2016年12月。由2位评价员独立进行文献筛选、基本资料提取和偏倚风险评估,采用RevMan 5.3软件进行Meta分析。结果:共纳入8篇RCT,计556例患者。Meta分析显示,与对照组比较,针刺治疗干燥综合征在提高临床疗效(RR=1.40,95%CI=[1.24,1.58],P﹤0.000 01)、改善Schirmer试验(WMD=3.24,95%CI=[2.98,3.49],P﹤0.000 01)、延长泪膜破碎时间(WMD=4.36,95%CI=[0.87,7.85],P﹤0.000 01)、增加唾液流率(WMD=3.19,95%CI=[3.10,3.28],P﹤0.000 01)、降低免疫球蛋白G(WMD=-1.85,95%CI=[-2.91,-0.80],P=0.000 6)方面存在优势;但在降低红细胞沉降率(WMD=-10.04,95%CI=[-20.69,0.60],P=0.06)方面,2组比较差异无统计学意义。结论:针刺治疗干燥综合征在提高患者临床疗效、改善泪腺和涎腺功能、降低免疫反应等方面优于常规治疗。鉴于纳入研究存在缺陷,期待更多高质量RCT加以验证。

Objective：To investigate the clinical efficacy of acupuncture in the treatment of sjogren＇s syndrome in order to provide evidence for its clinical practice.Methods：A retrieval was made to collect the randomized clinical trials （ RCT ） of sjogren＇s syndrome treated with acupuncture from CNKI,VIP and Wan Fang data （from the establishment of the databases to December,2016 ） .Independent screening,basic data extraction and bias risk assessment were carried out by two reviewers and a meta-analysis was made with software RevMan 5.3.Results：A total of 8 RCTs and 556 patients were included.The meta-analysis showed that,compared with the control group,treating sj6gren＇s syndrome with acupuncture had advantages on the aspects of improving clinical curative effect （ RR = 1.40,95% CI = [ 1.24,1.58 ] ,P 〈 0.000 01 ） ,improving Schirmer test （ WMD = 3.24,95%CI = [ 2.98,3.49 ] ,P 〈 0.000 01） and prolonging the tear break-up time （ WMD = 4.36,95%CI, E 0.87,7.85 ] ,P 〈 0.000 01 ） ,increasing saliva flow rate （WMD = 3.19,95%CI = [ 3.10,3.28 ] ,P 〈 0.000 01 ） , and decreasing immunoglobulin G （ WMD = -1.85,95%CI = [ -2.91,-0.80 ] ,P = 0.000 6 ） ;but the difference of decreasing erythrocyte sedimentation rate （ WMD = -10.04,95%CI = [-20.69,0.60 ] ,P =0.06 ） between the two groups was not statistically significant.Conclusion：Treating sj6gren＇s syndrome with acupuncture is superior to routine treatment in improving the clinical efficacy, improving the function of the lacrimal gland and salivary gland,and reducing the immune response.In view of the shortcomings of the study, more high-quality RCTs are expected to be validated.