电针治疗椎动脉型颈椎病的系统评价

Systematic Evaluation of Treating Cervical Spondylosis of Vertebral Artery Type by Electroacupuncture

目的:系统评价电针治疗椎动脉型颈椎病的临床疗效和安全性。方法:计算机检索Cochrane Library、PubMed、中国知网(CNKI)、万方(WanFang)、维普(VIP)等数据库收录的电针治疗椎动脉型颈椎病的随机对照试验,检索时间为数据库建立至2017年12月。采用Review Manager5.3软件对纳入的研究进行Meta分析。结果:共纳入12篇中文文献,973例患者。Meta分析结果:电针治疗椎动脉型颈椎病的临床总有效率、椎基底动脉血流速度与西药对比有优势(总有效率:OR=4.35,95%CI=[2.34,8.10],P<0.000 01。左椎动脉血流速:MD=5.80,95%CI=[4.28,7.33],P<0.000 01。右椎动脉血流速:MD=4.70,95%CI=[3.11,6.28],P<0.000 01。基底动脉血流速:MD=3.32,95%CI=[1.53,5.11],P=0.000 3)。电针治疗椎动脉型颈椎病总有效率与牵引对比有优势(OR=4.37,95%CI=[1.99,9.57],P<0.000 2)。电针治疗椎动脉型颈椎病总有效率与针刺对比无明显优势(OR=3.09,95%CI=[0.77,12.39],P=0.11)。结论:现有的证据表明电针治疗椎动脉型颈椎病能减轻椎动脉型颈椎病患者症状,改善血流动力学。但纳入研究数量偏少且质量偏低,尚需要更多高质量文献来验证其疗效。

Objective：To systematically evaluate the clinical efficacy and safety of the treatment of cervical spondylosis of vertebral artery type by electroacupuncture.Methods：Randomized controlled trials of treating cervical spondylosis of vertebral artery type by electroacupuncture were retrieved in databases as Cochrane Library,PubMed,CNKI,Wan Fang and VIP（from the establishment of the database to December 2017）.Software Review Manager 5.3 was used for Meta-analyses.Results：A total of 12 Chinese literatures with totally 973 patients were included.The Meta analysis results were as follows：the total efficiency of the electroacupuncture and the basilar artery blood flow speed were superior to those treated with Western Medicine（the total effective rate：OR = 4.35,95%CI = [2.34,8.10],P 〈0.000 01;left vertebral artery blood flow speed：MD = 5.80,95%CI = [4.28,7.33],P 〈0.000 01;right vertebral artery blood flow speed：MD = 4.70,95%CI = [3.11,6.28],P 〈0.000 01;basilar artery blood flow speed：MD = 3.32,95%CI = [1.53,5.11],P = 0.000 3）.The total efficiency is superior to traction（OR = 4.37,95%CI = [1.99,9.57],P〈 0.000 2）;the total efficiency has no obvious advantages compared with needles（OR = 3.09,95%CI = [0.77,12.39],P = 0.11）.Conclussion：The existing evidence shows that electroacupuncture can reduce the symptoms of cervical spondylosis of vertebral artery type and improve hemodynamics,but the number of the included studies is less and the quality is not high,so more high quality literature is needed to verify the effects.