Korea Institute of Oriental Medicine, Daejeon, 305-811, South Korea.
Evid Based Complement Alternat Med. 2009 Sep;6 Suppl 1(Suppl 1):59-64. doi: 10.1093/ecam/nep085.
The aim of this systematic review is to compile and critically evaluate the evidence from randomized clinical trials (RCTs) for the effectiveness of acupuncture using constitutional medicine compared to standard acupuncture. Ten databases were searched through to December 2008 without language restrictions. We also hand-searched nine Korean journals of oriental medicine. We included prospective RCTs of any form of acupuncture with or without electrical stimulation. The included trials had to investigate constitutional medicine. There were no restrictions on population characteristics. Forty-one relevant studies were identified, and three RCTs were included. The methodological quality of the trials was variable. One RCT found Sasang constitutional acupuncture to be superior to standard acupuncture in terms of the Unified PD Rating Scale and freezing gate in Parkinson's disease (PD). Another two RCTs reported favorable effects of eight constitutional acupuncture on pain reduction in patients with herniated nucleus pulposi and knee osteoarthritis. Meta-analysis demonstrated positive results for eight constitutional acupuncture compared to standard acupuncture on pain reduction (weighted mean difference: 10 cm VAS, 1.69, 95% CI 0.85-2.54, P < 0.0001; heterogeneity: tau(2) = 0.00, chi(2) = 0.00, P = 0.96, I(2) = 0%). Our results provide suggestive evidence for the effectiveness of constitutional acupuncture in treating pain conditions compared to standard acupuncture. However, the total number of RCTs and the total sample size included in our analysis were too small to draw definite conclusions. Future RCTs should assess larger patient samples with longer treatment periods and appropriate controls.
本系统评价的目的是整理并批判性评估随机临床试验（RCT）的证据，以比较体质医学与标准针灸的疗效。通过检索 10 个数据库（截止至 2008 年 12 月，无语言限制）和 9 种韩国东方医学杂志，共检索到 41 项相关研究，其中 3 项 RCT 被纳入。这些试验包括任何形式的针灸，包括电刺激。所纳入的试验必须对体质医学进行研究。对人群特征没有任何限制。试验的方法学质量参差不齐。一项 RCT 发现，在帕金森病（PD）患者中，Sasang 体质针灸在统一 PD 评定量表和冻结门方面优于标准针灸。另外两项 RCT 报告了 8 种体质针灸对椎间盘突出症和膝骨关节炎患者疼痛减轻的有利作用。Meta 分析显示，与标准针灸相比，8 种体质针灸在减轻疼痛方面具有积极效果（加权均数差：10cmVAS，1.69，95%CI0.85-2.54，P<0.0001；异质性：tau(2)=0.00，chi(2)=0.00，P=0.96，I(2)=0%）。我们的结果为体质针灸在治疗疼痛方面优于标准针灸提供了有价值的证据。然而，我们分析中纳入的 RCT 总数和总样本量太小，无法得出明确的结论。未来的 RCT 应评估更大的患者样本，治疗期更长，并采用适当的对照。
