推拿治疗广泛性焦虑症的系统评价及GRADE证据分级

Systematic Review and GRADE Evidence Classification of Massage in Treatment of Generalized Anxiety Disorder

目的:系统评价推拿治疗广泛性焦虑症的临床疗效及其证据分级。方法:计算机检索中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)、万方数据库、PubMed、Cochrane Library,查找推拿治疗广泛性焦虑症的随机对照临床文献。提取纳入文献的原始数据后进行质量评价,运用RevMan5.3软件进行Meta分析,采用GRADE软件对分析结果进行证据级别评价。结果:最终纳入12篇研究文献,共817例患者,其中治疗组414例,对照组403例,Meta分析结果显示,在改善广泛性焦虑症的总有效率方面推拿具有一定优势(P<0.0001)。在改善汉密尔顿焦虑量表(HAMA)评分方面,单纯推拿疗法与对照组比较两组疗效差异无统计学意义(P=0.37),而推拿联合其他疗法则较对照组具有明显优势(P=0.04)。在推拿治疗本病期间,不良反应的发生率与对照组比较明显降低(P=0.02)。结论:推拿治疗广泛性焦虑症具有优势,同时还可降低不良反应发生率。

Objective:To systematically evaluate the clinical curative efficacy and evidence classification of massage in the treatment of generalized anxiety disorder.Methods:Chinese National Knowledge Infrastructure(CNKI),VIP Chinese Sci-tech Journal Full-text Database(VIP),Wanfang Database,PubMed and Cochrane Library were searched by computer for randomized controlled clinical literature of massage in the treatment of generalized anxiety disorder.After extracting the original data included in the literature,the quality was evaluated.The RevMan5.3 software was used for Meta analysis,and the GRADE software was used to evaluate the evidence level of the analysis results.Results:A total of 12 articles were included,including 414 patients in the treatment group and 403 patients in the control group.The results of Meta analysis showed that massage had a certain advantage in improving the total effective rate of generalized anxiety disorder(P<0.0001).In terms of improving the Hamilton anxiety scale(HAMA)score,the difference between the two groups in the curative effect(simple massage therapy compared with that of the control group)was not statistically significant(P=0.37),while massage combined with other therapies had obvious advantages compared with that of the control group(P=0.04).During the period of massage treatment,the incidence of adverse reactions in the treatment group was significantly lower than that in the control group(P=0.02).Conclusion:Massage has advantages in the treatment of generalized anxiety disorder,and it can reduce the incidence of adverse reactions.