针灸治疗甲基苯丙胺依赖者戒断综合征的meta分析

Meta-analysis of acupuncture in the treatment of methamphetamine dependent withdrawal syndrome

目的 运用meta分析方法系统评价针灸对于甲基苯丙胺(methamphetamine, MA)依赖者戒断综合征的临床疗效。方法 通过系统检索中国知网(CNKI)、万方(WANFANG)、维普数据库(VIP)和中国生物医学数据库(CBM),PubMed、Cochrane Library数据库自建库到2020年5月所有关于针灸治疗MA依赖者戒断综合征的随机对照临床试验(randomized clinical trial, RCT)文献。由两名研究者根据文献的纳排标准对文献进行筛选,用Cochrane协作网对文献作文献质量评价,运用RevMan5.3软件对文献进行meta分析。结果 共纳入13篇文献,纳入病例总数为851例,meta分析结果显示,与对照组相比,针灸可有效改善焦虑症状[MD=-5.50,95%CI(-5.75,-5.25),P<0.00001],有效改善抑郁症状[MD=-10.26,95%CI(-10.68,-9.85),P<0.00001],有效改善戒断症状[MD=-3.97,95%CI(-5.88,-2.05),P<0.0001],有效改善失眠症状[MD=-9.30,95%CI(-12.67,-5.94),P<0.00001]。结论 针灸治疗MA依赖者戒断症状具有明显的临床疗效。但是本研究纳入的样本量小,外文文献相对较少,纳入文献的试验设计不够严谨,故还需要大样本、多中心的RCT试验来进一步验证。

Objective To systematically evaluate the clinical effects of acupuncture therapy on abstinence syndromes of methylamphetamine(MA) addicts using meta-analysis. Methods We collected all randomized comparison clinical trial(RCT) literatures on acupuncture treatment effects on MA abstinence syndromes from the retrieval systems of CNKI, WANGFANG, VIP and CBM, PubMed and Cochrane Library database since the construction of their database to May 2020. Two researchers screened the literatures according to the arrangement standards. Subsequently, the Cochrane collaboration network was used to evaluate the literature quality and the RevMan 5.3 software was used to do meta-analysis of the literature. Results A total of 13 literatures and 851 cases were included. Meta-analysis results show that compared with the control group, the acupuncture therapy can effectively improve anxiety symptoms[MD=-5.50,95%CI(-5.75,-5.25), P<0.00001], depression[MD=-10.26,95%CI(-10.68,-9.85), P<0.00001], abstinence[MD=-3.97,95%CI(-5.88,-2.05), P<0.0001], insomnia[MD=-9.30,95%CI(-12.67,-5.94), P<0.00001]. Conclusion Acupuncture therapy has obvious clinical curative effects on treating abstinence symptoms of MA addicts. However, the samples included were limited. There are relatively few international literatures. Furthermore, the experimental design of the included literatures is not rigorous enough. Therefore, large-sample and multi-center RCT experiments are needed for further verification.