督灸治疗强直性脊柱炎临床疗效的Meta分析

Meta-analysis of Clinical Efficacy of Moxibustion on Governor Vessel in Treating Ankylosing Spondylitis

目的:系统评价督灸治疗强直性脊柱炎的临床疗效。方法:计算机检索Pub Med数据库、EMbase、The Cochrane Library、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普(VIP)及万方(WANFANG DATA)等数据库,检索时间为数据库建立至2018年3月。以督灸单独或联合西药治疗强直性脊柱炎的临床随机对照试验(RCT)为研究对象,由2位研究员独立筛选文献,提取文献资料及评估偏倚风险,并采用Rev Man 5.3软件对数据进行分析。结果:共纳入10篇RCT文献,总样本量为705例,其中试验组352例,对照组353例。Meta分析结果显示:7篇文献显示督灸有效率更高(RR=1.23,95%CI=[1.13,1.35],P<0.000 01),且试验组VAS评分(WMD=-1.35,95%CI=[-2.16,0.53],P=0.001)、晨僵时间(WMD=-1.35,95%CI=[-2.16,0.53],P=0.001)、C-反应蛋白(WMD=-10.36,95%CI=[-17.48,-3.24],P=0.004)、红细胞沉降率(WMD=-8.80,95%CI=[-12.11,-5.49],P<0.000 01)等指标改善均优于对照组。6篇文献提及不良反应,其余4篇未提及。结论:督灸治疗强直性脊柱炎较其他单用西医治疗具有一定的优势;但由于本次Meta分析纳入的研究存在总体质量较低,数量少、结局指标不统一等问题,故今后需要更多高质量的随机对照双盲试验来验证督灸治疗强直性脊柱炎的疗效。

Objective：To systematically evaluate the clinical efficacy of moxibustion on Governor Vessel in treating ankylosing spondylitis.Methods：Databases such as PubMed,EMbase,The Cochrane Library,CBM,CNKI,VIP and WANFANG DATA were retrieved by computer to find randomized controlled trials（RCT）of treating ankylosing spondylitis with moxibustion on Governor Vessel alone or combined with western medicine（from the establishment of the databases to March 2018）.Two researchers independently screened the literature,extracted the literature and assessed the risk of bias,and analyzed the data using software RevMan 5.3.Results：A total of 10 RCT articles with 705 sample cases were included,including 352 experimental groups and 353 control groups.The results of Meta-analysis showed that the effective rate of moxibustion on Governor Vessel was higher in seven articles（RR = 1.23,95%CI = [1.13,1.35],P 〈 0.000 01）,and their VAS（WMD = - 1.35,95%CI =[- 2.16,0.53],P = 0.001）,morning stiffness time（WMD = - 1.35,95%CI =[- 2.16,0.53],P = 0.001）,C-reactive protein（WMD = - 10.36,95%CI =[- 17.48,- 3.24],P = 0.004）and erythrocyte sedimentation rate（WMD = - 8.80,95%CI =[- 12.11,- 5.49],P 〈 0.000 01）were better than those of the control group.Six of them mentioned adverse reactions,and 4 of them didn’t.Conclusion：Moxibustion on Governor Vessel has some advantages over ,other treatments with Western medicine alone.More higher-quality randomized controlled double-blind trials will be needed to verify the curative effect of moxibustion on Governor Vessel in treating ankylosing spondylitis.