针灸对比药物治疗肾绞痛临床疗效的Meta分析

Meta-Analysis of Clinical Efficacy of Acupuncture Versus Drugs in the Treatment of Renal Colic

目的:系统评价针灸对比药物治疗肾绞痛的疗效。方法:对建库以来至2018年5月发表在PubMed、Cochrane Library、EMbase、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普(VIP)和万方数据库的文献进行检索,收集针灸与药物治疗肾绞痛的随机对照试验研究,提取相关资料并采用Cochrane系统评价手册5.1进行质量评价,应用Revman Manager 5.3软件进行Meta分析。结果:共有13篇文献符合纳入标准,总纳入1131例患者。Meta分析结果提示:与对照组相比,针灸组的止痛总有效率较高[RR=1.12,95%CI(1.06,1.17),P<0.001],且针灸可以缩短疼痛开始缓解时间[MD=-9.92,95%CI(-12.85,-8.10),P<0.001];但两组间治疗后的VAS评分无统计学差异。结论:针灸治疗肾绞痛与单纯药物疗法相比,疗效尚可观,操作简便,不良反应相对较少,值得临床广泛推广。但受纳入研究数量和质量上的限制,仍需要开展更多临床随机对照试验验证上述结论。

Objective To evaluate the efficacy of acupuncture versus drug in the treatment of renal colic.Methods Electronic databases including PubMed database,the Cochrane Library,EMbase,CBM,China Knowledge Network(CNKI),VVIP and Wanfang Data were searched(from the publication of the journal to May 2018)and collected the randomized controlled trial of acupuncture and medication for renal colic.Relevant data were extracted and quality evaluation was performed using the Cochrane System Evaluator's Manual 5.1,and Meta analysis was performed using Revman Manager 5.3 software.Results A total of 13 RCTs were included.A total of 1131 cases were involved.The results of Meta-analysis showed that,compared with the control group,the total analgesic effect was higher in the acupuncture group[RR=1.12,95%CI(1.06,1.17),P<0.00001],and the acupuncture group could shorten the time to start pain relief[MD=-9.92,95%CI(-12.85,-8.10),P<0.00001].But there was no statistical difference in VAS scores between the two groups after treatment.Conclusion Compared with simple drug therapy,acupuncture treatment of renal colic has obvious advantages,simple operation and relatively few side effects.It is worthy of widespread clinical promotion.However,due to the quantitative and qualitative limitations of the included studies,more clinical randomized controlled trials are still needed to verify the above conclusions.