火针治疗痛风性关节炎临床研究的Meta分析

Clinical Study on Heated Needling for Treatment of Gouty Arthritis:A Meta-analysis

【目的】系统评价火针治疗痛风性关节炎的临床疗效。【方法】计算机检索中国知网期刊全文数据库(CNKI)、维普期刊数据库(VIP)、万方数据知识服务平台(Wanfang)、中国医院知识总库(CHKD)、中国生物医学文献数据库(CBM)、美国医学在线(PubMed)数据库、Embase数据库,检索并纳入火针治疗痛风性关节炎的随机对照试验(RCT)研究文献。根据纳入及排除标准,进行文献筛选、资料提取及质量评价后,应用RevMan 5.3软件进行Meta分析。【结果】共纳入12篇文献,共895例痛风性关节炎患者。Meta分析结果显示,与西药组相比,火针治疗痛风性关节炎总有效率[OR=3.30,95%CI(2.02,5.38),Z=4.78,P<0.000 01]、视觉模拟量表(VAS)评分[MD=-1.30,95%CI(-1.64,-0.96),P<0.000 01]、血尿酸(UA)含量[MD=-40.20,95%CI(-66.85,-13.55),P=0.003]、疼痛持续时间[MD=-1.66,95%CI=(-2.09,-1.23),P<0.000 01]、疼痛缓解时间[MD=-1.67,95%CI=(-1.78,-1.57),P<0.000 01]疗效更佳。在改善症状体征积分方面,火针与西药治疗差异无统计学意义。【结论】火针治疗痛风性关节炎能更快、更有效地缓解痛风性关节炎患者的疼痛症状,降低血尿酸含量,近期疗效肯定。但鉴于纳入文献数量较少,高质量文献不多,尚需在今后临床试验中加以验证。

Objective To systematically evaluate the clinical efficacy of heated needling for treatment of gouty arthritis.Methods We searched out the randomized controlled trials(RCTs)on heated needling for gouty arthritis from CNKI,VIP,Wanfang,CHKD,CBM,Pub Med,Embase databases by computer.After literature screening,data extraction and quality evaluation according to the inclusion and exclusion criteria,Meta-analysis was carried out by using Rev Man 5.3 software.Results A total of 12 literatures involving 895 patients with gouty arthritis were included.The results of Meta-analysis showed that,compared with the western medicine group,the total effective rate of heated needling for gouty arthritis[OR=3.30,95%CI(2.02,5.38),Z=4.78,P<0.000 01],visual analogue scale(VAS)score[MD=-1.30,95%CI(-1.64,-0.96),P<0.000 01],blood uric acid level[MD=-40.20,95%CI(-66.85,-13.55),P=0.003],pain durationtime[MD=-1.66,95%CI=(-2.09,-1.23),P<0.000 01],and pain relief time[MD=-1.67,95%CI=(-1.78,-1.57),P<0.000 01]had significant differences.There were no significant differences in improving the scores of symptoms and signs between the two groups.Conclusion Heated needling is effective for relieving the pain of gouty arthritis patients faster and more effectively,and can reduce the blood uric acid level,and has definite short-term effect.However,due to the small number of included literatures and the lack of high-quality studies,the above conclusions need to be further verified in future clinical trials.