针灸治疗腕管综合征疗效的meta分析

Acupuncture in patients with carpal tunnel syndrome:a meta-analysis

目的系统评价腕管综合征患者应用针灸治疗的疗效。方法检索the ISI Web of Knowledge Databases、PubMed、EMbase、CENTRAL、CBM、CNKI和万方数据库等,全面收集国内外针灸治疗腕管综合征的随机对照试验(RCTs),同时手工检索纳入文献的参考文献,检索时间均为建库至2017年10月1日。使用RevMan 5.2软件进行meta分析。按照相关纳入、排除标准原则,采用GRADE系统进行分析。结果纳入5个研究,共160例患者。Meta分析结果显示,与非针灸组相比,针灸组腕管综合征患者的末端运动潜伏期显著缩短(SMD=-1.56,95%CI-2.21～-0.91,P<0.000 01)、末端感觉潜伏期显著缩短(SMD=-0.62,95%CI-1.08～-0.16,P=0.008)、神经传导速度显著增快(MD=3.12,95%CI 1.52～4.72,P=0.000 1)、全球症状评分明显增高(MD=0.29,95%CI 0.13～0.45,P=0.000 3)。结论使用针灸治疗腕管综合征有效,但是因为原始研究的质量均比较低,故建议临床慎重选择针灸治疗法。

Objective To evaluate the efficiency of acupuncture in patients with carpal tunnel syndrome.Methods The databases such as the ISI Web of Knowledge databases,PubMed,EMbase,Cochrane Central Register of Controlled Trials(CENTRAL),CBM,CNKI and WanFang from establishment to October 1,2017 were searched,and the randomized controlled trials(RCTs)about acupuncture in patients with carpal tunnel syndrome were collected.After study selection,meta-analysis was performed by using the RevMan 5.2 software.In accordance with the principles of relevant inclusion and exclusion criteria,the level of evidence was assessed by using the GRADE system.Results Five studies involving 160 patients were included.The results of meta-analysis showed that compared with the non-acupuncture group,distal motor latency shortened obviously(SMD=-1.56,95% CI-2.21--0.91,P<0.000 01),distal sensory latency shortened obviously(SMD=-0.62,95% CI-1.08--0.16,P=0.008),nerve conduction velocity fast obviously(MD=3.12,95% CI 1.52-4.72,P=0.000 1),global symptom score heightened obviously(MD=0.29,95% CI 0.13-0.45,P=0.000 3).Conclusion Acupuncture is effective in carpal tunnel syndrome.However,because of the low quality of the original research,we suggest that the acupuncture method should be carefully selected in clinical practice.