针刺改善慢性疼痛患者情绪障碍的Meta分析

Effect of acupuncture on emotional disorder in patients with chronic pain:a Meta-analysis

目的:系统评价针刺对偏头痛及膝骨性关节炎患者情绪障碍的改善作用及其有效时限。方法:计算机检索Cochrane图书馆(Cochrane Library)、Pub Med、荷兰医学文献数据库(EMbase)、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(Sino Med)、维普中文科技期刊数据库(VIP)、万方学术期刊全文数据库(Wanfang)自建库至2018年12月针刺治疗偏头痛或膝骨性关节炎的随机对照试验。使用Cochrane系统评价手册5.1.0版偏倚风险评估工具对纳入的试验进行方法学质量评价,Rev Man5.3软件进行Meta分析。结果:共纳入12篇文献,病例数2450例。在即时效应方面,针刺组患者偏头痛特异性生活质量问卷(MSQ)情感功能副表评分高于对照组(6.38[2.78,9.98],I 2=25%);在健康调查简表(SF-36/SF-12)精神健康副表、西班牙生活质量指数(PQLC)量表心理功能及消极情绪副表评分上,针刺组与对照组比较差异无统计学意义。治疗后3个月,针刺组MSQ情感功能副表评分高于对照组(9.66[3.06,16.25],I 2=44%);针刺组与对照组SF-36、SF-12精神健康副表评分比较差异无统计学意义;治疗后3~6个月及6个月以上时,针刺组与对照组各评分比较差异均无统计学意义。结论:针刺可有效保持偏头痛患者情绪健康,该效应可持续至治疗后3个月,但对膝骨性关节炎引起的情绪障碍无明显改善作用。

Objective To systematically review the effect of acupuncture on emotional disorder in the patients with migraine and knee osteoarthritis and its effect time limit. Methods The randomized controlled trials of acupuncture for migraine or knee osteoarthritis were retrieved from the databases, starting from the time of establishment through to December, 2018, i.e. the Cochrane Library, Pub Med, EMbase, CNKI, Sino Med, VIP and Wanfang. The bias risk assessment tool of Cochrane Review Manual 5.1.0 was adopted to evaluate the quality of trials in methodology. Rev Man 5.3 software was used for the Meta-analysis. Results A total of 12 articles were included, with 2450 cases. Regarding the immediate effect, the score of the emotional function subscale of migraine-specific quality-of-life questionnaire(MSQ) in the acupuncture group was higher than the control group(6.38[2.78,9.98], I 2=25%). In view of the emotional function subscale of the short-form of health survey(SF-36/SF-12), and the scores of the mental function and negative mode scale in Spain’s index of quality of life(PQLC), there were no significant differences in the scores between the acupuncture group and the control group. In 3 months of treatment, the score of the emotional function subscale of MSQ in the acupuncture group was higher than the control group(9.66 [3.06,16.25], I 2=44%). The difference in the score of the mental health subscale of SF-36 and SF-12 was not significant between the acupuncture group and the control group. In 3 to 6 months of treatment, as well as in over 6 months of treatment,the score of every scale was not different statistically between the acupuncture group and the control group. Conclusion Acupuncture effectively maintains the healthy emotion in the patients with migraine and the effect is sustainable for 3 months after treatment. But the improvement of acupuncture is not remarkable in emotional disorder induced by knee osteoarthritis.