McCarney R W, Brinkhaus B, Lasserson T J, Linde K
Department of Psychological Medicine, Imperial College London, Room 4.06, Paterson Centre, 20 South Wharf Road, London, UK, W2 1PD.
Cochrane Database Syst Rev. 2004;2003(1):CD000008. doi: 10.1002/14651858.CD000008.pub2.
Acupuncture has traditionally been used to treat asthma in China and is used increasingly for this purpose internationally.
The objective of this review was to assess the effects of acupuncture for the treatment of asthma or asthma-like symptoms.
We searched the Cochrane Airways Group trials register (searched August 2003), the Cochrane Complementary Medicine Field trials register, the Alternative Medicine Database (August 2003) and reference lists of articles. We also contacted trialists and researchers in the field of complementary and alternative medical research.
Randomised and possibly randomised trials using needle acupuncture or other forms of stimulation of acupuncture. Any form of control treatment was considered (no treatment in addition to conventional asthma treatment, sham or placebo interventions, active comparator interventions). Studies were included provided outcome was assessed at one week or more.
At least two reviewers independently assessed trial quality. A reviewer experienced in acupuncture assessed the adequacy of the active and sham acupunctures used in the studies. Study authors were contacted for missing information.
Eleven studies met the inclusion criteria with 324 participants. Trial reporting was poor and trial quality was deemed inadequate to generalise findings. There was variation in the type of active and sham acupunctures, the outcomes measured and time-points presented. The points used in the sham arm of some studies are used for the treatment of asthma according to traditional Chinese medicine. Two studies used individualised treatment strategies and one study used a combination strategy of formula acupuncture with the addition of individualised points. No statistically significant or clinically relevant effects were found for acupuncture compared to sham acupuncture. Data from two small studies were pooled for lung function (post-treatment FEV1): Standardised Mean Difference 0.12, 95% confidence interval -0.31 to 0.55).
REVIEWER'S CONCLUSIONS: There is not enough evidence to make recommendations about the value of acupuncture in asthma treatment. Further research needs to consider the complexities and different types of acupuncture.
在中国，针灸传统上一直用于治疗哮喘，并且在国际上也越来越多地用于此目的。
本综述的目的是评估针灸治疗哮喘或哮喘样症状的效果。
我们检索了Cochrane Airways Group试验注册库（2003年8月检索）、Cochrane补充医学领域试验注册库、替代医学数据库（2003年8月）以及文章的参考文献列表。我们还联系了补充和替代医学研究领域的试验者和研究人员。
使用针刺或其他形式针刺刺激的随机及可能随机的试验。考虑任何形式的对照治疗（除传统哮喘治疗外不进行治疗、假手术或安慰剂干预、活性对照干预）。纳入的研究要求结局评估时间为一周或更长时间。
至少两名评审员独立评估试验质量。一名针灸经验丰富的评审员评估研究中使用的活性针刺和假针刺的充分性。联系研究作者获取缺失信息。
11项研究符合纳入标准，共324名参与者。试验报告质量较差，试验质量被认为不足以推广研究结果。活性针刺和假针刺的类型、测量的结局和呈现的时间点存在差异。一些研究中假针刺组使用的穴位根据中医理论是用于治疗哮喘的。两项研究采用个体化治疗策略，一项研究采用配方针灸加个体化穴位的联合策略。与假针刺相比，未发现针灸有统计学显著或临床相关的效果。两项小型研究的数据合并用于肺功能（治疗后FEV1）：标准化均数差0.12，95%置信区间-0.31至0.55）。
没有足够证据就针灸在哮喘治疗中的价值提出建议。进一步的研究需要考虑针灸的复杂性和不同类型。
