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三伏穴位贴敷治疗稳定期哮喘:随机对照试验的系统评价和Meta分析

Sanfu acupoint herbal patching for stable asthma: A systematic review and meta-analysis of randomised controlled trials.

作者信息

Zhou Fen, Liang Ning, Maier Manfred, Liu Jian-Ping

机构信息

School of Nursing, Beijing University of Chinese Medicine, Beijing, 11 Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China; Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine; 11 Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China.

Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine; 11 Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China.

出版信息

Complement Ther Med. 2017 Feb;30:40-53. doi: 10.1016/j.ctim.2016.11.007. Epub 2016 Nov 19.

Abstract

BACKGROUND

Sanfu acupoint herbal patching (SAHP) is extensively used in people with stable asthma in China. However, the evidence available is scarce. This systematic review aims to evaluate the preventive and therapeutic effect and safety of SAHP in people with stable asthma.

METHODS

We searched seven electronic databases for randomised controlled trials (RCTs). The Cochrane risk of bias tool was utilised to evaluate the methodological quality of the included studies and RevMan 5.3 and GRADEpro 3.6.1 were applied to perform data analyses.

RESULTS

A total of 34 RCTs involving 3313 participants were included. The overall methodological quality of the trials was of high risk of bias. SAHP plus conventional therapy (CT) decreased the mean frequency (times per year) of asthma exacerbations compared with CT alone (MD: -1.42; 95% CI: -2.19 to -0.65; 7 RCTs), and similar effect was found for SAHP versus sham SAHP (MD: 0.42; 95%CI: 0.26-0.69; 1 RCT). For lung function (including PEF%, FEV% and FEV/FVC), SAHP plus CT showed better effect than CT alone, and so did SAHP versus sham SAHP on PEF and PEF%. Adverse effects in the SAHP groups were reported to be mild and well tolerated.

CONCLUSIONS

SAHP alone or combined with CT appears to be more effective than sham SAHP or CT on reduction of asthma exacerbations, improving lung function, and SAHP seems to be safe. However, the findings should be interpreted with caution due to limitations in trial quality. Further, rigorously designed, large-scale trials are warranted for robust evidence.

摘要

背景

三伏穴位贴敷在中国广泛应用于稳定期哮喘患者。然而,现有证据稀少。本系统评价旨在评估三伏穴位贴敷对稳定期哮喘患者的预防、治疗效果及安全性。

方法

我们检索了七个电子数据库以查找随机对照试验(RCT)。采用Cochrane偏倚风险工具评估纳入研究的方法学质量,并应用RevMan 5.3和GRADEpro 3.6.1进行数据分析。

结果

共纳入34项RCT,涉及3313名参与者。试验的总体方法学质量存在较高偏倚风险。与单纯常规治疗(CT)相比,三伏穴位贴敷联合CT可降低哮喘发作的平均频率(每年发作次数)(MD:-1.42;95%CI:-2.19至-0.65;7项RCT),三伏穴位贴敷与假三伏穴位贴敷相比也有类似效果(MD:0.42;95%CI:0.26 - 0.69;1项RCT)。对于肺功能(包括呼气峰流速百分比、第一秒用力呼气容积百分比和第一秒用力呼气容积/用力肺活量),三伏穴位贴敷联合CT比单纯CT效果更好,三伏穴位贴敷与假三伏穴位贴敷相比在呼气峰流速和呼气峰流速百分比方面也有更好效果。三伏穴位贴敷组的不良反应据报道较轻且耐受性良好。

结论

单独使用三伏穴位贴敷或与CT联合使用在减少哮喘发作、改善肺功能方面似乎比假三伏穴位贴敷或CT更有效,且三伏穴位贴敷似乎是安全的。然而,由于试验质量的局限性,这些结果应谨慎解读。此外,需要进行更严格设计的大规模试验以获得有力证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43e0/5531441/14c60ddf3b2b/nihms880729f1.jpg

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