穴位埋线疗法治疗原发性高血压有效性的Meta分析

The Effectiveness of Acupoint Catgut Embedding in the Treatment of Essential Hypertension:a Meta-analysis

目的:系统评价穴位埋线疗法治疗原发性高血压的疗效。方法:计算机检索PubMed、The Cochrane Library、Embase、Web of Science、WanFang Data、维普(China science and technology journal database,VIP)、中国知网(China National knowledge infrastructure,CNKI)和中国生物医学文献数据库(China biology medicine disc,CBM)数据库,搜集有关原发性高血压的随机对照试验(randomized controlled trial,RCT),检索时限均从建库至2021年6月1日。由两名研究者独立筛选文献,提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果:共纳入12个RCT,包括1022例患者。Meta分析结果显示:试验组的有效率(OR=3.71,95%CI:2.62~5.27,P<0.00001)、收缩压(MD=-5.84,95%CI:-9.39~-2.28,P=0.001)、舒张压(MD=-4.61,95%CI:-6.93~-2.28,P=0.0001)、甘油三酯(MD=-0.06,95%CI:-0.08~-0.04,P<0.00001)、高密度脂蛋白胆固醇(MD=-0.01,95%CI:-0.02~-0.00,P=0.004)、低密度脂蛋白胆固醇差异(MD=0.09,95%CI:0.03~0.14,P=0.001)、体质量指数(Body Mass Index,BMI)(MD=-2.51,95%CI:-4.64~-0.37,P=0.02)、中医证候积分水平(MD=-6.08,95%CI:-10.9~-1.27,P=0.01)均优于对照组,差异具有统计学意义。结论:现有证据表明,穴位埋线疗法治疗原发性高血压患者的疗效优于常规治疗。但受研究数量和质量限制,上述结论尚需开展更多高质量的研究予以验证。

Objective:To systematically assess clinical effects of acupoint catgut embedding in the treatment of essential hypertension(EH).Methods:Randomized controlled trial(RCT)of EH were retrieved from PubMed,The Cochrane Library,Embase,Web of Science,Wanfang data,VIP,CNKI and CBMdisc,and the time limit ranged between the establishment of the database to June 1,2021.Two researchers independently screened the literature,extracted the data and assessed the risk of bias of the included studies,RevMan 5.3 software was adopted to perform Meta analysis.Results:The study has included 12 RCTs,involving 1022 patients.The results of Meta analysis showed that:the effective rate(OR=3.71,95%CI:2.62-5.27,P<0.00001),systolic pressure(MD=-5.84,95%CI:-9.39--2.28,P=0.001),diastolic pressure(MD=-4.61,95%CI:-6.39--2.28,P=0.0001),triglyceride(MD=-0.06,95%CI:-0.08--0.04,P<0.00001),high density lipoprotein cholesterol(MD=-0.01,95%CI:-0.02--0.00,P=0.004),low density lipoprotein cholesterol(MD=0.09,95%CI:0.03-0.14,P=0.001),BMI(MD=-2.51,95%CI:-4.64--0.37,P=0.02)and TCM syndrome integrals(MD=-6.08,95%CI:-10.9--1.27,P=0.01)of the experiment group were better than these of the control group,and the difference had statistical meaning.Conclusion:The existing evidence shows that the efficacy of acupoint catgut embedding in the treatment of EH is better than that of routine therapy.The above conclusions need to be verified by more high-quality trials due to the limitations in the quantity and quality of the included studies.