揿针治疗变应性鼻炎临床疗效的Meta分析

Meta-analysis on clinical efficacy of ringheaded thumbtack needle in the treatment of allergic rhinitis

目的:运用Meta分析评估揿针治疗变应性鼻炎(AR)的有效性和安全性。方法:检索自建库至2022年11月中国知网、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库、PubMed、Embase、Web of Science中关于揿针治疗AR的临床研究。两名研究人员独立筛选文献并提取有关资料,其中总有效率、AR视觉模拟量尺(VAS)评分、鼻结膜炎生存质量评分(RQLQ)、复发率为主要结局指标,次要结局指标包括症状体征量化评分、“四分法”症状评价量表等。用Stata软件对所有纳入的研究数据进行Meta分析。结果:共纳入22篇临床研究,涉及1 491名参与者。Meta分析结果显示,揿针治疗AR的总有效率高于中西医常规疗法[RR=1.20,95%CI(1.14,1.26),P<0.001];复发率低于中西医常规疗法[OR=0.35,95%CI(0.14,0.89),P=0.027];VAS评分低于中西医常规疗法[WMD=-1.30,95%CI(-1.85,-0.75),P<0.001];RQLQ评分低于中西医常规疗法[WMD=-6.75,95%CI(-12.74,-0.76),P=0.027]。结论:基于目前的研究,揿针疗法可提高总有效率,降低疾病复发,改善AR发作的不适,并且无明显不良反应。但研究之间的异质性偏大,仍需大样本、设计严谨、符合国际规范的临床研究方案提高证据质量级别。

Objective To evaluate the efficacy and safety of ringheaded thrumbtack needle in the treatment of allergic rhinitis(AR).Methods Clinical studies about treatment of AR with ringheaded thrumbtack needle were searched from databases of CNKI,Wanfang,China Science and Technology Journal,China Biology Medicine disc,PubMed,Embase and Web of Science from their inception to November 2022.Two researchers independently screened the literature and collected related information.The total effective rate,visual analogue scale(VAS) for AR,rhinoconjunctivitis quality of life questionnaire(RQLQ),and recurrence rate were the main outcome indicators.Secondary outcome indicators included quantitative scores of symptoms and signs,‘quartering' symptom evaluation scale,etc.All the included studies were subjected to Meta-analysis using Stata software.Results A total of 22 clinical studies involving 1 491 participants were included.The results of Meta-analysis indicated that the total effective rate of ringheaded thrumbtack needle in the treatment of AR was higher than that of traditional Chinese and Western medicine [RR=1.20,95%CI(1.14,1.26),P<0.001],and recurrence rate is lower than conventional therapy [OR=0.35,95%CI(0.14,0.89),P=0.027].Moreover,The VAS score [WMD=-1.30,95%CI(-1.85,-0.75),P<0.001] and RQLQ score [WMD=-6.75,95%CI(-12.74,-0.76),P=0.027] of AR treated by ringheaded thrumbtack needle were lower than those of traditional Chinese and Western medicine.Conclusion Ringheaded thrumbtack needle can improve the total effective rate,reduce the disease recurrence,and improve the symptoms of discomfort when AR outbreaks,and has no significant adverse reactions.However,the reliability is limited.Thus,it is still necessary to improve the level of evidence quality by including researches with large samples,rigorous design and international standards.