灸法治疗强直性脊柱炎临床疗效的Meta分析

Meta-analysis of the Clinical Efficacy of Moxibustion in Treating Ankylosing Spondylitis

目的评价灸法治疗强直性脊柱炎的临床疗效。方法计算机检索PubMed、Embase、中国生物医学文献数据库、中国期刊全文数据库和万方数据库,收集关于灸法治疗强直性脊柱炎的随机对照试验(RCT),采用Cochrane Review Handbook 5.1对符合纳入标准的临床研究进行资料提取和质量评价,并采用RevMan5.3统计软件进行Meta分析。结果 25篇文献符合纳入要求,共2087例患者,其中试验组1048例,对照组1039例。Meta分析结果显示灸法治疗强直性脊柱炎的总有效率优于西药,RR值为1.17,95%CI(1.04,1.32),P=0.008;灸法联合西药治疗强直性脊柱炎的总有效率优于西药,RR值为1.14,95%CI(1.09,1.18),P<0.01。结论灸法相对西药、灸法联合西药与单纯西药相比,临床疗效较好,不良反应较少。但所纳入的临床研究质量相对偏低,需要更多高质量、多中心的随机双盲临床研究进一步补充验证。

Objective To evaluate the clinical efficacy of moxibustion in treating ankylosing spondylitis. Method By computer retrieval, literatures about randomized controlled trial on moxibustion in treating ankylosing spondylitis were collected from Pubmed, EMbase, China Biology Medicine disc（CBMdisc）, China National Knowledge Infrastructure（CNKI）, and Wan Fang database. After data extraction and quality evaluation by using Cochrane Review Handbook 5.1, the eligible clinical trials underwent meta-analysis by using RevMen5.3 software. Result A total of 25 articles met the inclusion criteria, including 2 087 cases with 1 048 cases in the experiment group and 1 039 cases in the control group. The meta-analysis showed that the total effective rate of moxibustion in treating ankylosing spondylitis was superior to that of Western medicine [RR=1.17, 95%CI（1.04, 1.32）, P=0.008]. Moreover, the total effective rate of moxibustion plus Western medicine in treating ankylosing spondylitis was superior to that of Western medicine [RR=1.14, 95%CI（1.09, 1.18）, P0.01]. Conclusion Compared to Western medicine alone, moxibustion and moxibustion plus Western medicine can produce a better clinical efficacy and less adverse reactions. But due to the relative low quality of the eligible clinical studies, more randomized double-blind clinical trials with multiple centers and high quality are expected for further verification.