针刺治疗面肌痉挛有效性的国内文献的系统评价

Systematic Review of Domestic Literature on the Effectiveness of Acupuncture in the Treatment of facial Muscle Spasm

目的系统评价针刺为主的针灸疗法是否对面肌痉挛有效。方法计算机检索2010年1月到2020年1月中国知网数据库(CNKI)、万方数据库、重庆维普数据库公开发表的针灸治疗面肌痉挛的随机对照临床试验文献。由2名研究员独立筛选文献、提取资料、根据Cochrane系统评价手册5.1.0 RCT偏倚风险评估工具及改良后的Jadad量表评分标准评价文献质量后,采用Cochrane协作网提供的RevMan5.3版统计软件进行Meta分析。发表性偏倚采用倒漏斗图估计。结果纳入11篇文献,共涉及861名面肌痉挛患者。针刺治疗面肌痉挛临床疗效(OR=3.78,95%CI为[2.75,5.19],合并效应量检验(Z=8.20,P<0.00001))优于卡马西平。结论针刺治疗面肌痉挛临床疗效较好,但需要更多大样本、高质量的随机对照的临床试验进一步证实。

Objective To systematically review whether needling-based acupuncture therapy is effective for facial muscle spasm.Methods The literature of randomized controlled clinical trials of acupuncture for facial muscle spasm published publicly in the China Knowledge Base(CNKI),Wanfang database,and VIP database from January 2010 to January 2020 was computer searched.Meta-analysis was performed by 2 researchers after independently screening the literature,extracting information,and evaluating the quality of the literature according to the Cochrane Systematic Evaluation Manual 5.1.0 RCT risk of bias assessment tool and the modified Jadad scale scoring criteria,using the statistical software RevMan version 5.3 provided by the Cochrane Collaboration Network.Publication bias was estimated using an inverted funnel plot.Results Eleven publications involving a total of 861 patients with facial myasthenia were included.The clinical efficacy of acupuncture for facial myasthenia(OR=3.78,95%CI[2.75,5.19],combined effect size test(Z=8.20,P<0.00001))was superior to that of carbamazepine.Conclusion The clinical efficacy of acupuncture in the treatment of facial spasm is good,but further confirmation is needed in more randomized controlled clinical trials with large samples and high quality.