不同针灸疗法联合抗精神病药治疗精神分裂症的网状Meta分析

Network Meta-analysis of Different Acupuncture and Moxibustion Therapies Combined with Antipsychotic Drugs in the Treatment of Schizophrenia

目的:评价拟通过运用贝叶斯网状分析方法来建立基于随机证据的针灸治疗精神分裂症的疗效。方法:采用特定检索策略检索PubMed、Web of Science、Embase、The Cochrane Library、国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、中国生物医学文献数据库(CBM)中已公开发表的针灸疗法联合抗精神疾病西药治疗精神分裂症的随机对照试验(RCT),检索时限为各数据库建库至2021年4月1日。数据结果将由两位审查员独立提取,纳入试验的质量将根据Cochrane干预系统评价手册的指导方针进行评估。数据运用Stata 15.1和ADDIS 1.16.8软件进行分析。结果:共纳入60项RCT,共4810例患者。网状Meta分析结果显示:体针、体针+电针、头针+电针、耳针、低剂量用药与针灸、穴位注射和穴位埋线联合西药对精神分裂症患者症状的改善效果优于单用西药。Rank Probability结果显示,体针结合抗精神疾病西药在降低PANSS量表3个结果中均排名第一。结论:针灸疗法辅助治疗在改善精神分裂症方面具有显著优势,体针结合抗精神疾病西药可能成为改善精神分裂症状最佳针灸治疗方案。

Objective:To evaluate the efficacy of acupuncture and moxibustion therapies in the treatment of schizophrenia based on randomized evidence using Bayesian network Meta-analysis.Methods:PubMed,Web of Science,Embase,The Cochrane Library,CNKI,CSPD,CCD,and CBM were searched using a specified retrieval strategy for published randomized controlled trials(RCTs)of acupuncture and moxibustion therapies combined with antipsychotic drugs in the treatment of schizophrenia from database inception to April 1,2021.Data results were extracted independently by two investigators,and the quality of included RCTs was assessed in accordance with the Cochrane Handbook for Systematic Reviews of Interventions.Data were analyzed using Stata 15.1 and ADDIS 1.16.8.Results:Sixty RCTs covering 4810 cases were included.The network Meta-analysis results showed that body acupuncture(BA),BA+EA,scalp acupuncture(SA)+EA,auricular acupuncture(AA),low-dose medication and acupuncture,acupoint injection(AI),and acupoint catgut embedding(ACE)combined with western medicine(WM)were superior to WM along in improving the symptoms of schizophrenia.The Rank Probability results showed that BA combined with antipsychotic drugs ranked first in all three PANSS scale results.Conclusion:Acupuncture and moxibustion therapies have significant advantages in improving schizophrenia,and BA combined with antipsychotic drugs may become the optimal acupuncture and moxibustion treatment plan for improving schizophrenia symptoms.This study has been registered on the“PROSPERO”website,and the registration number is CRD42021227403.