针灸治疗类风湿关节炎的临床疗效及相关机制：一项系统评价
Clinical Efficacy of Acupuncture on Rheumatoid Arthritis and Associated Mechanisms: A Systemic Review.
作者信息
Chou Pei-Chi, Chu Heng-Yi
机构信息
School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
Department of Rehabilitation, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
出版信息
Evid Based Complement Alternat Med. 2018 Apr 12;2018:8596918. doi: 10.1155/2018/8596918. eCollection 2018.
OBJECTIVE
The objective of this review is to investigate the detailed existing scientific information about the clinical efficacy of acupuncture on rheumatoid arthritis (RA) conditions and to reveal the proposed mechanisms.
METHODS
We searched the PubMed, EMBASE, Cochrane, AMED (Allied and Complementary Medicine), NCCAM (The National Center for Complementary and Alternative Medicine), and CNKI (China National Knowledge Infrastructure) databases to identify relevant monographs and related references from 1974 to 2018. Chinese journals and theses/dissertations were hand searched.
RESULTS
43 studies were recruited. Each research was analyzed for study design, subject characteristics, intervention, selected acupoints, assessment parameters, proposed mechanisms, and results/conclusions.
CONCLUSIONS
In our review, we concluded that acupuncture alone or combined with other treatment modalities is beneficial to the clinical conditions of RA without adverse effects reported and can improve function and quality of life and is worth trying. Several important possible mechanisms were summarized including anti-inflammatory effect, antioxidative effect, and regulation of immune system function. However, there is still inconsistency regarding the clinical efficacy and lack of well-designed human/animal double-blinded RCTs. Future discussion for further agreement on taking traditional Chinese medicine (TCM) theory into consideration as much as possible is a top priority.
目的
本综述的目的是调查关于针灸治疗类风湿性关节炎（RA）临床疗效的详细现有科学信息，并揭示其潜在机制。
方法
我们检索了PubMed、EMBASE、Cochrane、AMED（联合与补充医学）、NCCAM（美国国立补充与替代医学中心）和CNKI（中国知网）数据库，以识别1974年至2018年期间的相关专著和参考文献。对手工检索中文期刊和论文/学位论文。
结果
共纳入43项研究。对每项研究的研究设计、受试者特征、干预措施、所选穴位、评估参数、潜在机制以及结果/结论进行了分析。
结论
在我们的综述中，我们得出结论，单独使用针灸或与其他治疗方式联合使用对RA的临床状况有益，且未报告有不良反应，可改善功能和生活质量，值得一试。总结了几个重要的潜在机制，包括抗炎作用、抗氧化作用和免疫系统功能调节。然而，在临床疗效方面仍存在不一致性，且缺乏设计良好的人体/动物双盲随机对照试验。未来尽可能多地考虑将中医理论纳入进一步共识的讨论是当务之急。
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