针刺治疗乳腺癌相关淋巴水肿的系统评价再评价

Reevaluation of systematic review acupuncture in the trentment of breast cancer related lymphedema

目的对针刺治疗乳腺癌相关淋巴水肿(BCRL)的效果进行方法学质量、证据质量评价。方法检索Web of Science、Medline、PubMed、Cochrane Library、Embase、中国生物医学文献数据库(CBM)、万方、中国知网(CNKI)、VIP,检索时限均从建库至2021年7月,检索有关于针刺治疗BCRL系统评价或Meta分析。采用AMSTAR 2评价方法学质量,用GRADE、CERQual评价证据质量。结果利用AMSTAR 2评价结果显示,所纳入的文献4篇为极低质量,2篇为低质量。GRADE评价结果显示,有4篇质量评级为中级,1篇质量评级为低级,1篇质量评级为极低级,0篇质量评级为高级。CERQual评价结果显示,有4篇质量评级为中级,2篇质量评级为低级,0篇质量评级为极低级或高级。结论目前针刺治疗BRCL系统评价的整体质量一般,尤其在说明纳入排除文献的原因、纳入研究的方法学质量、纳入研究的科学性应用到结论推导上等方面存在严重不足。

Objective The methodological quality and evidence quality of acupuncture in the treatment of breast cancer related lymphedema(BCRL)were evaluated.Methods The Web of Science,Medline,PubMed,Cochrane Library,Embase,China Biology Medicine(CBM),Wanfang Data,China National Knowledge Infrastructure(CNKI),and VIP were searched from inception to July 2021 for systematic review or meta-analysis of acupuncture in the trentment of BCRL.AMSTAR 2 was used to evaluate the methodological quality,and GRADE and CERQual were used to evaluate the quality of evidence.Results The results of AMSTAR 2 evaluation showed that 4 articles were of very low quality and 2 articles were of low quality.The results of GRADE evaluation showed that there were 4 articles with intermediate quality rating,1 article with low quality rating,1 article with very low quality rating,and no quality rating was advanced.The results of CERQual evaluation showed that 4 articles had intermediate quality ratings,2 articles had low quality ratings,and no quality ratings were very low or high.Conclusion At present,the overall quality of systematic reviews of acupuncture treatment of BRCL is general,especially in explaining the reasons for inclusion and exclusion of literature,the methodological quality of included studies,and the scientific application of included studies to conclusion derivation.