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天灸疗法治疗成年哮喘患者:一项荟萃分析

Tian jiu therapy for the treatment of asthma in adult patients: a meta-analysis.

作者信息

Chan Clara W C, Lee Sau Chun, Lo Kwai Ching, Wong Hei Kiu, Li Lei

机构信息

School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong Pokfulam , Hong Kong, People's Republic of China .

出版信息

J Altern Complement Med. 2015 Apr;21(4):200-7. doi: 10.1089/acm.2014.0009. Epub 2015 Mar 11.

Abstract

OBJECTIVES

To review and evaluate the efficacy and safety of tian jiu therapy on san fu tian for adults with asthma.

METHODS

A literature search through August 31, 2013, was done to identify comparative studies evaluating effective rate, pulmonary function, immune response, recurrence rate, quality of life, and adverse events. The Cochrane Library, PubMed, EMBASE, and Chinese National Knowledge Infrastructure were searched; only randomized controlled trials with treatment groups using tian jiu therapy were included. Cochrane Collaboration's risk of bias tool and Review Manager software, version 5.2, were used for the data synthesis.

RESULTS

Six studies involving 657 patients were identified. tian jiu therapy was more effective than the control intervention (odds ratio [OR], 3.51; 95% confidence interval [CI], 2.05-6.00; p<0.00001; I(2)=18%). The treatment group had a bigger decrease in IgE level (standard mean difference [SMD], -1.40; 95% CI, -2.18 to -0.63; p=0.0004; I(2)=85%) and Eosinophil (Eos) level (SMD, -4.26; 95% CI, -6.28 to -2.23; p<0.00001; I(2)=91%) compared with the control group. Included studies had a high risk of bias. Few adverse effects were reported in the included studies, and no serious adverse responses occurred. Adverse effects did not result in any dropouts.

CONCLUSIONS

All studies indicated that tian jiu therapy has a positive effect on adults with asthma and that it is relatively safe because of its noninvasive nature. However, the limitations of the research design of the existing studies resulted in high risk of bias. More randomized controlled trials of better methodologic quality are needed to further confirm efficacy and safety of this therapy.

摘要

目的

回顾和评估三伏天灸疗法对成年哮喘患者的疗效和安全性。

方法

检索截至2013年8月31日的文献,以确定评估有效率、肺功能、免疫反应、复发率、生活质量和不良事件的比较研究。检索了Cochrane图书馆、PubMed、EMBASE和中国知网;仅纳入使用天灸疗法的治疗组的随机对照试验。使用Cochrane协作网的偏倚风险工具和5.2版Review Manager软件进行数据合成。

结果

共纳入6项研究,涉及657例患者。天灸疗法比对照干预更有效(优势比[OR],3.51;95%置信区间[CI],2.05 - 6.00;p < 0.00001;I² = 18%)。与对照组相比,治疗组的IgE水平下降幅度更大(标准均数差[SMD],-1.40;95% CI,-2.18至-0.63;p = 0.0004;I² = 85%),嗜酸性粒细胞(Eos)水平下降幅度更大(SMD,-4.26;95% CI,-6.28至-2.23;p < 0.00001;I² = 91%)。纳入的研究存在较高的偏倚风险。纳入研究中报告的不良反应较少,未发生严重不良反应。不良反应未导致任何患者退出研究。

结论

所有研究表明,天灸疗法对成年哮喘患者有积极作用,且因其非侵入性而相对安全。然而,现有研究的研究设计局限性导致了较高的偏倚风险。需要更多方法学质量更好的随机对照试验来进一步证实该疗法的疗效和安全性。

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本文引用的文献

1
Asthma outcomes: biomarkers.哮喘结局:生物标志物。
J Allergy Clin Immunol. 2012 Mar;129(3 Suppl):S9-23. doi: 10.1016/j.jaci.2011.12.979.
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Expert Rev Pharmacoecon Outcomes Res. 2011 Aug;11(4):447-53. doi: 10.1586/erp.11.48.
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