单纯针刺治疗干眼临床疗效的Meta分析

Acupuncture alone for dry eye:A Meta-analysis

目的 系统评价单纯针刺治疗干眼的临床疗效。方法 计算机检索2010年1月—2021年8月中国知网、万方、维普、中国生物医学文献数据库、PubMed、The Cochrane Library、Embase数据库,纳入针刺治疗干眼的临床随机对照试验(RCT)研究。运用Cochrane协作网提供的Stata 14软件对纳入文献的临床总有效率、泪液分泌量、泪膜破裂时间、主观症状积分作为主要结局指标进行Meta分析。结果 共纳入11篇文献,966例患者。与西医治疗相比,单纯针刺治疗干眼能够提高总有效率[OR=6.112,95%CI(4.427,8.436),Z=11.010,P=0.001]、患者泪液分泌量[WMD=2.732,95%CI(1.676,3.789),Z=5.070,P=0.003]、泪膜破裂时间[WMD=2.653,95%CI(0.907,4.399),Z=2.980,P=0.019]、主观症状积分[WMD=-2.282,95%CI(-2.905,-1.660),Z=7.190,P=0.027],差异均有统计学意义。结论 单纯针刺治疗干眼在提高总有效率、泪液分泌量、泪膜破裂时间、改善主观症状积分方面较西医治疗有一定优势,但鉴于存在一定文献发表偏倚,仍需要更多高质量的RCT试验来进一步证实其优势。

OBJECTIVE To evaluate the clinical efficacy of dry eye treated by acupuncture alone.METHODS From January 2010 to August 2021,Chinese and English databases including China National Knowledge Infrastructure(CNKI),Wanfang,VIP,CBM,PubMed and The Cochrane Library were searched by computer.Randomized controlled trial(RCT)study involving acupuncture treatment of dry eye were included.The total clinical response rate,tear secretion,tear film rupture time and subjective symptom scores were used as the main outcome indicators for Meta-analysis using Stata 14 software provided by the Cochrane Collaboration.RESULTS A total of 11 papers involved 966 patients were included.Compared with Western Medicine(WM)in dry eye treatment,acupuncture could improve the total effective rate[OR=6.112,95%CI(4.427,8.436),Z=11.010,P=0.001],increase tear secretion[WMD=2.732,95%CI(1.676,3.789),Z=5.070,P=0.003],increase the tear film break up time[WMD=2.653,95%CI(0.907,4.399),Z=2.980,P=0.019],improve the subjective symptom scores[WMD=-2.282,95%CI(-2.905,-1.660),Z=7.190,P=0.027],with statistically significant differences.CONCLUSIONS Acupuncture therapy has certain advantages over WM treatments in terms of total effective rate,increase of tear secretion,increase of tear film break up time,and improvement of subjective symptoms score.However,due to the potential publication bias in the literature,more high-quality RCT are needed to confirm these advantages.