针刺联合常规治疗干预慢性心力衰竭疗效的Meta分析

Therapeutic Effect of Acupuncture Combined with Conventional Treatment on Chronic Heart Failure:a Meta-analysis

目的:采用Meta分析评价针刺联合常规治疗干预慢性心力衰竭(CHF)的临床疗效。方法:检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学文献数据库(CBM)、PubMed、the Cochrane Library、EMbase等数据库自建库至2024年5月1日有关针刺联合常规治疗慢性心力衰竭的随机对照试验(RCTs)。采用Stata 16.0软件进行Meta分析。结果:共纳入26项研究,均为RCTs,涉及2243例CHF病人。Meta分析结果显示,针刺联合常规治疗方法可改善CHF病人心力衰竭总有效率[RR=1.23,95%CI(1.17,1.30),P<0.001]、提高左室射血分数(LVEF)[WMD=4.43,95%CI(2.33,6.53),P<0.001]、延长6 min步行试验(6MWT)距离[WMD=46.48,95%CI(29.93,63.03),P<0.001]、降低血清脑钠肽水平(BNP)[WMD=-143.10,95%CI(-204.86,-81.33),P<0.001]、降低明尼苏达心力衰竭生活质量调查表(MLHFQ)评分[WMD=-5.33,95%CI(-9.88,-0.79),P<0.001]。结论:现有证据表明,针刺联合常规治疗可显著改善CHF病人的临床疗效。

Objective:A Meta-analysis was used to evaluate the clinical efficacy of acupuncture combined with conventional treatment in the intervention of chronic heart failure(CHF).Methods:Randomized controlled trials(RCTs)of acupuncture combined with conventional treatment of chronic heart failure in the databases of China National Knowledge Infrastructure(CNKI),Wanfang Data,Wipro Chinese Full-text Database of Scientific and Technological Journals(VIP),Chinese Biomedical Literature Database(CBM),PubMed,the Cochrane Library,and EMbase were searched.The search period was from establishment of database to May 1,2024.Meta-analysis was performed using Stata 16.0 software.Results:A total of 26 studies were included,all of which were RCTs,involving 2243 patients with CHF.Meta-analysis showed that acupuncture combined with conventional treatment could improve the total effective rate of heart failure in CHF patients(RR=1.23,95%CI 1.17-1.30,P<0.001),increase left ventricular ejection fraction(LVEF)(WMD=4.43,95%CI 2.33-6.53,P<0.001),lengthened the 6-min walking test(6MWT)distance(WMD=46.48,95%CI 29.93-63.03,P<0.001),decreased the serum brain natriuretic peptide level(BNP)(WMD=-143.10,95%CI-204.86--81.33,P<0.001),with lower Minnesota Heart Failure Quality of Life Questionnaire(MLHFQ)score(WMD=-5.33,95%CI-9.88--0.79,P<0.001).Conclusion:The available evidence shows that acupuncture combined with conventional treatment can significantly improve the clinical efficacy of patients with CHF.