针灸治疗糖尿病胃轻瘫的临床证据

Survey clinical evidence of acupuncture therapy for Diabetic gastroparesis

目的:通过对针灸治疗糖尿病胃轻瘫相关文献的整理评价,提炼出质量相对较高的临床证据,以便于临床医师做出科学的决策。方法:全面检索相关文献,按照证据分级标准及质量评价标准从高到低选出能够回答对应临床问题的证据,并采用RevMan5.0统计结局指标。结果:共纳入A级证据3项,均为系统评价/meta-分析;B级证据20项;C级证据0项;D级证据9项;E级证据4项。其中纳入1项低质量B级证据针刺治疗糖尿病胃轻瘫的疗效;共纳入3项A级证据、1项高质量B级证据,15项低质量B级证据比较了针灸与西药的疗效;共纳入1项低质量B级证据比较了电针配合西药的疗效;目前尚未找到针灸与其他疗法相比的临床证据;共纳入1项低质量B级证据比较了不同刺灸法之间的疗效。结论:针灸治疗糖尿病胃轻瘫是有效的,在与西药对比方面亦具有疗效优势,并且针灸配合口服西药可达增效之功,可大多改善饱腹感、食欲不振、胃部压痛、嗳气、进食量、便质等临床症状,但仍需更多的大样本、多中心的临床试验或系统评价/Mate分析证明。

Objective:To evaluate the clinical studies of acupuncture for treatment of Diabetic gastroparesis and collect the high quality evidence for clinical decision-making reference.Methods:The documents of clinical study were comprehensively retrieved.According to criterion of evidencebased medicine,the evidence from high to low level were selected to answer corresponding clinical questions and RevMan 5.0 was used to analyze the final indicator.Results:A level of evidence is included in the system assessment/meta-analysis.Level B evidence are 20 items;C level evidence is 0;Class D evidence are 9;Class E evidence are 4.Among them,one of the low-quality b-level evidence acupuncture is used to treat diabetic gastroparesis.A total of 3 a-level evidences,1 high quality b-level evidence,15 low-quality b-grade evidence were compared with the efficacy of acupuncture and western medicine.A total of 1 low-quality grade B evidence was included to compare the efficacy of electroacupuncture with western medicine.There is no clinical evidence of acupuncture compared with other treatments.A total of 1 low-quality b-grade evidence was used to compare the efficacy of different moxibustion methods.Conclusion:Acupuncture and moxibustion treatment of diabetic gastroparesis is effective,also to have curative effect advantage in contrast with the western medicine,and acupuncture and oral western medicine can reach the work efficiency,can mostly improve satiety,loss of appetite,abdominal tenderness,belching,food intake,and quality,and the clinical symptoms,but still needs more large sample,multi-center clinical trial or system evaluation/Mate analysis certificate