艾灸治疗压疮病人效果的Meta分析

Treatment effect of moxibustion for patients with pressure ulcer:a Meta-analysis

[目的]系统评价艾灸治疗压疮病人的临床效果,为临床提供循证参考。[方法]通过计算机检索Cochrane Library、PubMed、EMBase、中国生物医学文献数据库、中国知网、万方数据库、维普数据库中公开发表的中文/英文文献,查找所有关于艾灸治疗压疮的随机对照试验(randomized controlled trials,RCTs),自建库至2019年8月内文献均纳入检索范围。对纳入文献的参考文献进行手工检索。按纳入排除标准由两人独立进行RCTs的筛选、资料提取和质量评价后,采用RevMan5.3软件进行有关数据的Meta分析。[结果]共纳入20个RCTs,包括1211例病人。两组病人压疮治愈率[OR=4.31,95%CI(3.24,5.74),P<0.00001]、压疮有效率[OR=8.67,95%CI(5.08,14.79),P<0.00001]、压疮愈合评价量表评分[MD=-1.14,95%CI(-1.42,-0.87),P<0.00001]、压疮愈合时间指数[MD=0.69,95%CI(0.32,1.06),P=0.0003]、压疮愈合时间亚组分析结果[MD=-4.81,95%CI(-5.94,-3.68)]比较,差异有统计学意义。两组压疮创面面积比较差异无统计学意义[MD=-5.48,95%CI(-12.58,1.62),P=0.13]。[结论]艾灸在改善压疮治疗效果方面有优越性,但由于纳入研究RCTs文献质量一般,还需更严格设计、更精细化、多中心、大样本的RCTs来证实。

Objective:To systematically evaluate the clinical treatment effects of moxibustion for patients with pressure ulcers,and to provide evidence-based reference for clinical practice.Methods:The randomized controlled trials(RCTs)about moxibustion in the treatment of pressure ulcer were retrieved from Cochrane Library,PubMed,EMBase,Chinese Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),Wanfang Database,Weipu Database(VIP).The literatures ares were included in the search from the establishment of the library to August 2019.The references of the included literatures were manually searched.Meta-analysis of the data was performed using RevMan 5.3 software after screening,data extraction and quality evaluation of RCTs independently by two persons according to the inclusion and exclusion criteria.Results:A total of 20 RCTs were enrolled,involving 1211 patients.The cure rate of pressure ulcer[OR=4.31,95%CI(3.24,5.74),P<0.00001],the effective rate of pressure ulcer[OR=8.67,95%CI(5.08,14.79),P<0.00001],pressure ulcer healing evaluation scale score[MD=-1.14,95%CI(-1.42,-0.87)],pressure ulcer healing time index in the intervention group[MD=0.69,95%CI(0.32,1.06),P=0.0003],and pressure ulcer healing time sub-group analysis results[MD=-4.81,95%CI(-5.94,-3.68)]were significantly better than that in the control group,and the difference was statistically significant.There was no significant difference in the area of pressure ulcer wound between the two groups[MD=-5.48,95%CI(-12.58,1.62),P=0.13].Conclusions:Moxibustion is effective in the treatment of pressure ulcer,which has certain advantages compared with other treatment methods.However,due to the general quality of the included RCTs,it needs more rigorous design,more refined,multi-center,large sample RCTs to confirm.