目的采用贝叶斯网状meta分析系统评价不同针刺方法治疗顽固性面瘫的临床效果。方法检索中国生物医学文献服务系统数据库、中国知网、维普网、万方数据知识服务平台、PubMed、Embase、Cochrane Library和Web of Science中针刺方法治疗顽...目的采用贝叶斯网状meta分析系统评价不同针刺方法治疗顽固性面瘫的临床效果。方法检索中国生物医学文献服务系统数据库、中国知网、维普网、万方数据知识服务平台、PubMed、Embase、Cochrane Library和Web of Science中针刺方法治疗顽固性面瘫的随机对照试验,检索时限为各库建库至2024年3月。由2名研究人员独立检索、筛选文献、提取数据、纳入符合标准的文献,用Cochrane推荐的“偏倚风险评估工具”评估其偏倚风险,最后通过Stata 17.0软件对临床有效率、临床治愈率和多伦多评分等结局指标进行网状meta分析。结果最终纳入29篇随机对照试验,共计2212例患者,其中试验组1108例,对照组1104例,共涉及15种针刺疗法。浮针、毫火针+电针、埋线、埋线+电针、火针+电针、穴位注射+针刺、放血+电针、放血+针刺、温针灸+电针、小针刀+针刺、电针的临床有效率均高于针刺,埋线+电针、火针+电针、放血+电针、温针灸+电针的临床有效率均高于电针,火针+电针、放血+电针的临床有效率均高于放血+针刺,埋线+电针的临床有效率高于火针+针刺(P<0.05)。浮针、毫火针+电针、埋线、埋线+电针、火针+针刺、火针+电针、穴位注射+针刺、放血+电针、放血+针刺、温针灸+电针、电针的临床治愈率均高于针刺,放血+电针、温针灸+电针的临床治愈率均高于电针,放血+电针的临床治愈率高于放血+针刺(P<0.05)。不同干预措施患者的多伦多评分比较,差异无统计学意义(P>0.05)。提高临床有效率排名前3位的干预措施为温针灸+电针、毫火针+电针、埋线+电针;提高临床治愈率排名前3位的干预措施为温针灸+电针、放血+电针、火针+电针;改善多伦多评分排名前3位的干预措施为浮针、埋线、小针刀+针刺。临床有效率和治愈率的散点全部位于倒漏斗图内且左右分布大致对称,提示发表偏倚风险的可能性较小。结论温针灸联合电针提高临床有效率和治愈率的效果显著,浮针在改善多伦多评分方面优势明显,但仍需开展高质量临床试验予以验证。展开更多
Based on feild outcrop survey,lithology observation and systematic sampling,and with the scanning electron microscope,rock pyrolysis,biomarker compound test and analysis,this paper discussed source rock characteristic...Based on feild outcrop survey,lithology observation and systematic sampling,and with the scanning electron microscope,rock pyrolysis,biomarker compound test and analysis,this paper discussed source rock characteristics and paleoenvironment in western Hubei.The lithology at the bottom of Lower Silurian Longmaxi Formationn in this study area is mainly dark carbonaceous shale,the mineral composition is mostly clay minerals,quartz and feldspar,the content of illite and kaolinite is high,but also contains a minor amount of strawberry pyrite and graptolite fossils.The test and analysishow that the total organic carbon content(TOC)of the source rock is 0.8-6.32%,the average value is 3.42%,and the vitrinite reflectance(Ro)is 1.57-2.95%.The type of organic matter is mainly typeⅡ2.The overall abundance of organic matter is high,and the degree of thermal evolution has reached the stage of high maturity and over maturity.All these have become the good material basis and conditions for the formation of shale gas.The paleoenvironment of the source rocks indicates that the organic matter is a mixed source of planktonic algae and bacteria material.The large amount of hopane also indicates that the bacterial activity is strong during the deposition of organic matter;The water of the ancient lake is almost freshwater and brackishwater in some parts;The redox property of the water is in a strong reduction environment and with a stable stratification,which is also conducive to the preservation of organic matter.The above research results will provide the application of shale gas exploration in western Hubei.展开更多
文摘目的采用贝叶斯网状meta分析系统评价不同针刺方法治疗顽固性面瘫的临床效果。方法检索中国生物医学文献服务系统数据库、中国知网、维普网、万方数据知识服务平台、PubMed、Embase、Cochrane Library和Web of Science中针刺方法治疗顽固性面瘫的随机对照试验,检索时限为各库建库至2024年3月。由2名研究人员独立检索、筛选文献、提取数据、纳入符合标准的文献,用Cochrane推荐的“偏倚风险评估工具”评估其偏倚风险,最后通过Stata 17.0软件对临床有效率、临床治愈率和多伦多评分等结局指标进行网状meta分析。结果最终纳入29篇随机对照试验,共计2212例患者,其中试验组1108例,对照组1104例,共涉及15种针刺疗法。浮针、毫火针+电针、埋线、埋线+电针、火针+电针、穴位注射+针刺、放血+电针、放血+针刺、温针灸+电针、小针刀+针刺、电针的临床有效率均高于针刺,埋线+电针、火针+电针、放血+电针、温针灸+电针的临床有效率均高于电针,火针+电针、放血+电针的临床有效率均高于放血+针刺,埋线+电针的临床有效率高于火针+针刺(P<0.05)。浮针、毫火针+电针、埋线、埋线+电针、火针+针刺、火针+电针、穴位注射+针刺、放血+电针、放血+针刺、温针灸+电针、电针的临床治愈率均高于针刺,放血+电针、温针灸+电针的临床治愈率均高于电针,放血+电针的临床治愈率高于放血+针刺(P<0.05)。不同干预措施患者的多伦多评分比较,差异无统计学意义(P>0.05)。提高临床有效率排名前3位的干预措施为温针灸+电针、毫火针+电针、埋线+电针;提高临床治愈率排名前3位的干预措施为温针灸+电针、放血+电针、火针+电针;改善多伦多评分排名前3位的干预措施为浮针、埋线、小针刀+针刺。临床有效率和治愈率的散点全部位于倒漏斗图内且左右分布大致对称,提示发表偏倚风险的可能性较小。结论温针灸联合电针提高临床有效率和治愈率的效果显著,浮针在改善多伦多评分方面优势明显,但仍需开展高质量临床试验予以验证。
基金Supported by project of National Natural Science Foundation of China(NSFC)(No.42072122).
文摘Based on feild outcrop survey,lithology observation and systematic sampling,and with the scanning electron microscope,rock pyrolysis,biomarker compound test and analysis,this paper discussed source rock characteristics and paleoenvironment in western Hubei.The lithology at the bottom of Lower Silurian Longmaxi Formationn in this study area is mainly dark carbonaceous shale,the mineral composition is mostly clay minerals,quartz and feldspar,the content of illite and kaolinite is high,but also contains a minor amount of strawberry pyrite and graptolite fossils.The test and analysishow that the total organic carbon content(TOC)of the source rock is 0.8-6.32%,the average value is 3.42%,and the vitrinite reflectance(Ro)is 1.57-2.95%.The type of organic matter is mainly typeⅡ2.The overall abundance of organic matter is high,and the degree of thermal evolution has reached the stage of high maturity and over maturity.All these have become the good material basis and conditions for the formation of shale gas.The paleoenvironment of the source rocks indicates that the organic matter is a mixed source of planktonic algae and bacteria material.The large amount of hopane also indicates that the bacterial activity is strong during the deposition of organic matter;The water of the ancient lake is almost freshwater and brackishwater in some parts;The redox property of the water is in a strong reduction environment and with a stable stratification,which is also conducive to the preservation of organic matter.The above research results will provide the application of shale gas exploration in western Hubei.
