穴位贴敷干预慢性阻塞性肺疾病疗效及安全性的系统评价再评价

Overviews of the efficacy and safety of acupoint application therapy for chronic obstructive pulmonary disease

目的:对穴位贴敷干预慢性阻塞性肺疾病的系统评价和Meta分析进行质量评价。方法:计算机检索Web of Science、the Cochrane Library、EMbase、PubMed、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普期刊(VIP)和万方数据服务平台(Wanfang)中穴位贴敷干预慢性阻塞性肺疾病的系统评价/Meta分析,检索时限为建库起至2022年4月。两名研究人员按照纳排标准独立筛选文献、提取数据,并运用AMSTAR 2、GRADE进行方法学质量和证据质量评价。结果:最终纳入9篇Meta分析,使用AMSTAR 2行方法学质量评价,发现9篇文献均为极低质量。GRADE证据分级显示,在39个结局指标中,中等质量14个,低质量18个,极低质量7个,无高级别证据。结论:穴位贴敷干预慢性阻塞性肺疾病有低质量循证医学证据支持,但系统评价方法学质量较低,且证据质量等级不高,有待进一步研究考证。

Objective:To evaluate the quality of the systematic review and meta-analysis of acupoint application on chronic obstructive pulmonary disease(COPD).Methods:Web of Science,the Cochrane Library,EMbase,PubMed,CBM,CNKI,VIP and Wanfang Data were searched for systematic reviews/meta-analysis on acupoint application intervention for COPD,and searching time was set from inception of the above databases to April,2022.Literatures and extracted data were screened by two researchers independently according to the inclusion and exclusion criteria.The AMSTAR 2 and GRADE were used to evaluate the methodological quality and quality of evidence.Results:A total of 9 Meta-analyses were finally included,and AMSTAR 2 evaluation results showed that the 9 papers were all of extremely low quality.The GRADE evidence classification showed that there were 14 indicators of medium quality,18 indicators of low-level quality,and 7 indicators of extremely low-level quality among 39 outcome indicators.There was no high-level evidence were found.Conclusion:The intervention of acupoint application on chronic obstructive pulmonary disease is supported by low-quality evidence-based medicine.However,the methodological quality of systematic reviews on COPD is low,and the level of evidence quality is not high,which needs further studies to confirm this conclusion.