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[纤维肌痛综合征针刺疗法的临床证据调查]

[Survey on clinical evidence of acupuncture therapy for fibromyalgia syndrome].

作者信息

Wang Xu, Du Yuan-Hao, Xiong Jun

机构信息

Tianjin University of Chinese Medicine, Tianjin 300193, China.

出版信息

Zhen Ci Yan Jiu. 2011 Jun;36(3):230-5.

Abstract

OBJECTIVE

To evaluate the clinical effect of acupuncture therapy for fibromyalgia syndrome (FMS) by analyzing the available studies so as to provide clinical decision-making reference.

METHODS

The published papers on clinical trails for acupuncture treatment of FMS were widely retrieved from Chinese Biomedical Databases (1979 - 2010), www. cnki. net (1979-2010), VIP China Scientific Journal Database (1989- 2010), Digital Periodicals on Wanfang Data (1998 - 2010), PubMed (1966-2010), etc. and by using key words of fibromyalgia syndrome and acupuncture. According to criterion of evidence-based medicine, the evidence from high to low quality levels was selected to answer corresponding clinical questions, and software RevMan 5.0 was used to analyze the final results.

RESULTS

There has been no enough clinical evidence showing definite efficacy of acupuncture for FMS. However, a Level-A study (being in line with conditions of large sample, multi-centers, randomized controlled trails) and a level-C study (having control group, but without distinct randomizing method) showed respectively that acupuncture might be superior to Amitriptyline and Brufen in relieving FMS. Moreover, a piece of evidence that acupuncture combined with western medicine was superior to western medicine alone was allocated to a level-B (having correct randomizing method and control group). Finally, only a level-C evidence proved that laser irradiation on acupoint might be superior to traditional acupuncture in improving FMS.

CONCLUSION

Acupuncture for FMS has a positive effect, and acupuncture combined with western medicine can strengthen the curative effect. However this conclusion should be proved further by randomized controlled double blind clinical trials with large samples.

摘要

目的

通过分析现有研究评估针刺疗法治疗纤维肌痛综合征(FMS)的临床效果,为临床决策提供参考。

方法

从中国生物医学数据库(1979 - 2010年)、www.cnki.net(1979 - 2010年)、维普中文科技期刊数据库(1989 - 2010年)、万方数据数字化期刊(1998 - 2010年)、PubMed(1966 - 2010年)等广泛检索针刺治疗FMS的临床研究论文,采用纤维肌痛综合征和针刺的关键词。根据循证医学标准,从高到低选择证据质量水平的证据来回答相应临床问题,并使用RevMan 5.0软件分析最终结果。

结果

尚无足够临床证据表明针刺对FMS有确切疗效。然而,一项A级研究(符合大样本、多中心、随机对照试验条件)和一项C级研究(有对照组,但随机方法不明确)分别显示针刺在缓解FMS方面可能优于阿米替林和布洛芬。此外,针刺联合西药优于单纯西药的一条证据被归为B级(随机方法正确且有对照组)。最后,仅有一条C级证据证明穴位激光照射在改善FMS方面可能优于传统针刺。

结论

针刺治疗FMS有积极作用,针刺联合西药可增强疗效。然而,这一结论应通过大样本随机对照双盲临床试验进一步证实。

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