针灸联合中医药治疗溃疡性结肠炎临床疗效的Meta分析

Meta-analysis of acupuncture and moxibustion combined with TCM in the treatment of ulcerative colitis

目的:分析针灸联合中医药治疗溃疡性结肠炎的临床疗效。方法:计算机检索数据库2010年1月-2021年12月权威医学期刊全文数据,筛选针灸联合中医药与西药对照治疗溃疡性结肠炎的随机对照试验(RCT),运用Corhrane评价法对所选文献风险偏倚评估,用Rev Man 5.3软件进行数据分析。结果:最终纳入11个RCT,共计936例患者。Meta分析结果显示,对比单用西药,(1)针灸联合中医药治疗可以提高溃疡性结肠炎患者临床总有效率[OR=3.07,95%CI(2.09,4.52),Z=5.7,P<0.00001];(2)缓解中医证候:腹痛[MD=-1.32,95%CI(-2.36,-0.28),Z=2.49,P=0.01];腹泻[MD=-1.95,95%CI(-3.30,-0.59),Z=2.82,P=0.005];黏液脓血便[MD=-1.28,95%CI(-2.44,-0.13),Z=2.17,P=0.03];里急后重[MD=-1.55,95%CI(-2.79,-0.31),Z=2.46,P=0.01];(3)改善中医证候积分[MD=-6.66,95%CI(-11.12,-2.19),Z=2.92,P=0.003];⑷降低结肠黏膜Baron评分[MD=-0.45,95%CI(-0.67,-0.23),Z=4.06,P<0.0001]。结论:对比单用西药,针灸联合中医药治疗溃疡性结肠炎有更好的临床疗效。可以明显改善腹痛、腹泻,促进肠道黏膜恢复,适合临床使用。

Objective:To analyze the clinical efficacy of acupuncture and moxibustion combined with TCM medicine on ulcerative colitis in using Meta.Methods:Using computers to search the full-text databases of authoritative medical journals from January 2010 to December 2021.Randomized controlled trials of acupuncture and moxibustion combined with TCM medicine and Western medicine was included.Using Corhrane evaluation method to evaluate the risk of bias of the literature,data analysis was performed with Revman 5.3 software.Results:There were 11 RCTs meeting the requirements of the standard,with a total of 936 patients.Meta-analysis showed that compared with western medicine alone:(1)The total rate of clinical effective was statistically significant[OR=3.07,95%CI(2.09,4.52),Z=5.7,P<0.00001];(2)Alleviate TCM symptoms:the abdominal pain symptoms[MD=-1.32,95%CI(-2.36,-0.28),Z=2.49,P=0.01];the diarrhea symptoms[MD=-1.95,95%CI(-3.30,-0.59),Z=2.82,P=0.005];the mucus purulent bloody stool[MD=-1.28,95%CI(-2.44,-0.13),Z=2.17,P=0.03];the tenesmus[MD=-1.55,95%CI(-2.79,-0.31),Z=2.46,P=0.01];(3)Improve TCM syndrome score:[MD=-6.66,95%CI(-11.12,-2.19),Z=2.92,P=0.003];(4)Decreased Baron score:[MD=-0.45,95%CI(-0.67,-0.23),Z=4.06,P<0.0001].Conclusion:Compared with western medicine alone,acupuncture and moxibustion combined with TCM medicine has better clinical effect on ulcerative colitis.It can significantly improve TCM medicine symptoms such as abdominal pain,diarrhea and promote mucosal recovery.Therefore it is suitable for clinical application.