近10年针灸治疗血管性痴呆的优势方案筛选研究

Selection study of optimized treatment plan of acupuncture for vascular dementia in recent 10 years

目的:基于临床证据,运用多指标决策分析法筛选出针灸治疗血管性痴呆的最优方案,为临床决策提供科学依据。方法:对中国知网、万方数据库、维普期刊全文数据库、PubMed、Cochrane Library和Embase自2009年1月1日至2018年12月31日发表的针灸治疗血管性痴呆的随机对照试验(RCT)进行全面的中英文检索。采用改良的Jadad量表对证据质量进行评价。采用极差变换法对确定的评价指标的量纲进行标准化处理,运用相对比较法确定每个指标的权重并对标准化矩阵进行加权处理,得出最优值和最劣值,计算各方案与最优值的相对贴近度,筛选出针灸治疗血管性痴呆的最优方案。结果:共纳入17项RCT,筛选出的针灸治疗血管性痴呆的最优方案为电针四神聪、百会、神庭、风池,每周治疗5次,共6周,30次。结论:基于现有临床证据和多指标决策结果,电针头穴为针灸治疗血管性痴呆的最优方案,临床可以通过指定刺激穴位而提高治疗该病的疗效。

Objective:To select the optimized treatment plan of acupuncture for vascular dementia by using multiple indexes decision-making method based on the clinical evidence.Methods:The randomized controlled trial(RCT)of acupuncture treatment for vascular dementia published in CNKI database,WANFANG database,VIP database,PubMed,Cochrane Library and Embase published from January 1,2009 to December 31,2018 were comprehensively collected.The modified Jadad scale was used to evaluate the quality of the RCTs.Then the evaluation indexes were selected and the dimensions of evaluation indexes were standardized by using extreme difference transformation method.The weight of each index was determined by using relative comparison method and the standardized matrix was weighted.Thus,the ideal solution and the negative ideal solution were obtained,and the relatively degree of each treatment plan to the ideal solution was calculated to propose the optimized plan of acupuncture for vascular dementia.Results:A total of 17 RCTs were included,the optimized plan of acupuncture for vascular dementia was using electroacupuncture on the head,Sishencong(EX-HN1),Baihui(DU20),Shenting(DU24),Fengchi(GB20),5 treatments per week for 6 weeks,30 treatments in total.Conclusion:Based on the current clinical evidence and the curative effect of acupuncture is illustrated by the results of multiple attribute decision,the optimized plan of acupuncture for vascular dementia is using electroacupuncture on the head.The clinical effect can be specified to acupuncture points and improve the curative effect of treatment of the disease.