针灸在不同时机介入治疗周围性面瘫疗效的Meta分析

Efficacy of acupuncture-moxibustion on peripheral facial paralysis at different time points:a Meta-analysis

目的:系统评价针灸于急性期介入与非急性期介入治疗周围性面瘫在有效性和安全性方面的差异。方法:计算机检索中国期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(Sino Med)、Pub Med、Cochrane图书馆(Cochrane Library)、谷歌学术(Google Scholar)数据库,搜集针灸治疗周围性面瘫临床试验文献,检索时限均为建库至2019年5月31日,由2位研究者独立对纳入文献进行资料提取和质量评价后,使用Rev Man 5.3软件进行Meta分析。结果:共纳入11篇文献,病例数1741例,Meta分析结果提示:(1)针灸治疗周围性面瘫急性期介入的治愈率高于非急性期介入(OR=2.45,95%CI [1.91,3.14],Z=7.06,P<0.01);(2)针灸急性期介入治疗周围性面瘫的平均痊愈时间短于非急性期介入(WMD=5.26,95%CI[3.44,7.08],Z=5.67,P<0.01);(3)对于随访6个月面瘫后遗症发生率,针灸急性期介入的后遗症发生率低于非急性期介入(OR=2.71,95%CI[1.26,5.84],Z=2.56,P<0.05);(4)有1项研究报告了观察组和对照组在治疗过程中均未发生不良反应。结论:基于目前证据,针灸急性期介入治疗周围性面瘫的疗效优于非急性期介入,可促进疾病的痊愈和缩短疗程,减少后遗症的发生,但尚需更多高质量、大样本的随机对照试验进一步验证其疗效。

Objective To systematically evaluate the efficacy and safety differences between acupuncture-moxibustion at acute stage and non-acute stage for peripheral facial paralysis. Methods The clinical trials regarding acupuncturemoxibustion for peripheral facial paralysis published before May 31 st 2019 were searched in databases of CNKI, WF, VIP, Sino Med, Pub Med, Cochrane Library and Google Scholar. The information of included studies was extracted and the quality was assessed by two independent researchers. The Meta-analysis was performed by using Rev Man 5.3 software. Results A total of 11 trials were included, involving 1741 patients. The Meta-analysis results showed that:(1) the curative rate of acupuncture-moxibustion at acute stage was higher than that at non-acute stage(OR=2.45, 95%CI: 1.91-3.14, Z=7.06, P<0.01);(2) the average curative time of acupuncture-moxibustion at acute stage were shorter than that of non-acute stage(WMD=5.26, 95%CI: 3.44, 7.08, Z=5.67, P<0.01);(3) the incidence rate of sequelae in 6-month follow up of acupuncture-moxibustion at acute stage were lower than that of non-acute stage(OR=2.71, 95%CI: 1.26, 5.84, Z=2.56,P<0.05);(4) one study reported that there were no adverse reactions during treatment in both treatment group and control group. Conclusion Based on current evidence, the efficacy of acupuncture-moxibustion at acute stage is superior to non-acute stage, which could promote the recovery of the disease and shorten the course of treatment, and reduce the occurrence of sequelae. More high-quality, large-sample randomized controlled trials are needed for further verification.