穴位贴敷治疗儿童咳嗽变异性哮喘有效性及安全性的系统评价

A systematic review of the effectiveness and safety of acupoint application in treating children with cough variant asthma

目的系统评价穴位贴敷治疗儿童咳嗽变异性哮喘的有效性及安全性。方法用计算机检索自建库至2020年2月中国期刊全文数据库(CNKI)、万方数据库、维普全文期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Cochrance Library、EMBase数据库中关于穴位贴敷疗法治疗儿童咳嗽变异性哮喘的临床文献,选择符合纳入标准的临床试验进行Meta分析。结果共纳入18篇随机对照试验,总计1407例患儿,统计分析后显示穴位贴敷治疗咳嗽变异性哮喘的总有效率优于对照组。在肺功能检测及哮喘控制测试(ACT)评分,穴位贴敷治疗咳嗽变异性哮喘的第1秒用力呼气容积(FEV1)、第一秒用力呼气量/最大肺活量(FEV1/FVC)、呼气峰流速值(PEF)及ACT评分明显优于对照组。在免疫功能方面,穴位贴敷治疗咳嗽变异性哮喘的IgM、IgG、IgA明显高于对照组,IgE值明显低于对照组。在远期疗效方面,随访期间穴位贴敷治疗咳嗽变异性哮喘的复发率及复发咳嗽消失时间明显低于对照组。以上研究结果差异均有统计学意义(P<0.05)。结论穴位贴敷疗法具有提高咳嗽变异性哮喘患儿治疗的总有效率,改善肺通气功能,提高机体免疫力,降低复发率,缩短复发咳嗽消失时间的作用。

Objective To systematically evaluate the effectiveness and safety of acupoint application in the treatment of children with cough variant asthma.Methods Relevant literatures on acupoint applications in treating cough variant asthma(CVA)in children were retrieved from electronic databases,including China National Knowledge Infrastructure(CNKI),WanFang Database,Chongqing VIP information Chinese scientific journals database(VIP),Chinese Biomedical Literature database(CBM),PubMed,Cochrane Library and EMbase database,from their inception till February 2020.Meta-analysis was conducted after extracting related data from the included studies.Results In total,18 randomized controlled trials(RCTs)involving 1407 children were selected for the meta-analysis.The analysis indicated that the total effective rate of acupoint applications in the treatment group was better than that in the control group.In terms of the pulmonary function test and ACT scores,the forced expiratory volume in one second(FEV1),forced expiratory volume in one second/forced vital capacity(FEV1/FVC),peak expiratory flow rate(PEF)and ACT scores were better in the treatment group than in the control group.Concerning immune function,IgM,IgG,and IgA values in the treatment group were significantly higher than those in the control group,while IgE values of treatment group were significantly lower.In terms of efficacy in the long run,the treatment group had lower rate of recurrent cough variant asthma and shorter duration spent in eliminating recurrent cough as compared to the control group.The differences in the above research results were statistically significant(P<0.05).Conclusion Acupoint applications can improve the overall efficacy of treatment in children with CVA,improve pulmonary ventilation,boost immunity,and reduce recurrence rate and shorten the duration spent in eliminating recurrent cough.