以针刺为主治疗慢性荨麻疹的Meta分析

A Meta-analysis of acupuncture therapy for chronic urticaria

目的:评价以针刺为主治疗慢性荨麻疹的疗效。方法:检索近10年来收录于中国期刊全文数据库(CNKI)、万方数据库、重庆维普中文科技期刊数据库(VIP)、中国生物医学文献数据库网络版(CBM)、PubMed、Embase、Cochrane Library等数据库中以针刺为主治疗慢性荨麻疹的随机对照试验(randomized controlled trial,RCT),以"荨麻疹or风疹块or瘾疹or风团"and"针灸疗法or针灸or针刺or电针or毫针or体针or穴"and"随机对照试验"以及"Urtica-ria or Urticarias or Hives"and"Acupuncture Therapy or Acupuncture Treatment"and"Randomized Controlled Trial or Randomized"等词组合检索。检索时间为2008年1月至2018年10月。对筛选得到的文献进行质量评价,设计数据提取表,最后使用Review Manager5.3软件对纳入文献进行分析。结果:检索到文献1095篇,共有16项RCT入选。Meta分析结果:总有效率方面,OR=3.85,95%CI为[2.61,5.69],P<0.00001。复发率方面,OR=0.28,95%CI为[0.14,0.55],P=0.0003。结论:从国内现有研究报道看,以针刺为主治疗慢性荨麻疹的疗效明显优于单独使用抗组胺药物,并且复发率更低。

Objective To evaluate the efficacy of acupuncture therapy in the treatment of chronic urticaria.Methods Randomized controlled trials of acupuncture treatment of chronic urticaria published from January of 2008 to October of 2018 were searched from databases of CNKI,VIP,Wanfang,CBM,PubMed,Embase and Cochrane Library by using key words"urticaria or urticarias""acupuncture therapy""acupuncture treatment"and"randomized controlled trial(RCT)".The retrieved RCT papers were input into EndNote X8 document management software for screening the qualified ones,followed by evaluating the quality of the screened papers.The data extraction table was designed,and the information and data needed for the research were accurately extracted.Finally,Review Manager 5.3 software was used to analyze the included literature.Results A total of 1095 articles were retrieved,and 16 RCTs were included finally.The Meta-analysis showed that the total therapeutic efficacy was OR=3.85,95%CI[2.61,5.69],P<0.00001.The diamonds for comparison between the acupuncture and control(medication)groups in the"Feng Tuan"(urticaria)number,itching,onset duration,swelling degree and scratch test scores were on the right side of the invalid line of forest maps.The recurrence rate(reported in 4 papers)was lower in the acupuncture group than in the control group(OR=0.28,95%CI being[0.14,0.55],P=0.0003).Conclusion Acupuncture treatment is significantly better than antihistamine administration alone in the treatment of chronic urticaria,with lower recurrence rate.High-quality clinical studies with rigorous design and large sample sizes are needed for providing more reliable evidence.