针灸对中风生活方式危险因素的疗效：系统评价。
Efficacy of acupuncture for lifestyle risk factors for stroke: A systematic review.
机构信息
Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
Nursing Research Centre, Western Sydney University & Western Sydney Local Health District, Blacktown Clinical & Research School, Blacktown Hospital, Sydney, New South Wales, Australia.
出版信息
PLoS One. 2018 Oct 26;13(10):e0206288. doi: 10.1371/journal.pone.0206288. eCollection 2018.
BACKGROUND
Modifications to lifestyle risk factors for stroke may help prevent stroke events. This systematic review aimed to identify and summarise the evidence of acupuncture interventions for those people with lifestyle risk factors for stroke, including alcohol-dependence, smoking-dependence, hypertension, and obesity.
METHODS
MEDLINE, CINAHL/EBSCO, SCOPUS, and Cochrane Database were searched from January 1996 to December 2016. Only randomised controlled trials (RCTs) with empirical research findings were included. PRISMA guidelines were followed and risk of bias was assessed via the Cochrane Collaboration risk of bias assessment tool. The systematic review reported in this paper has been registered on the PROSPERO (#CRD42017060490).
RESULTS
A total of 59 RCTs (5,650 participants) examining the use of acupuncture in treating lifestyle risk factors for stroke met the inclusion criteria. The seven RCTs focusing on alcohol-dependence showed substantial heterogeneity regarding intervention details. No evidence from meta-analysis has been found regarding post-intervention or long-term effect on blood pressure control for acupuncture compared to sham intervention. Relative to sham acupuncture, individuals receiving auricular acupressure for smoking-dependence reported lower numbers of consumed cigarettes per day (two RCTs, mean difference (MD) = -2.75 cigarettes/day; 95% confidence interval (CI) = -5.33, -0.17; p = 0.04). Compared to sham acupuncture those receiving acupuncture for obesity reported lower waist circumference (five RCTs, MD = -2.79 cm; 95% CI: -4.13, -1.46; p<0.001). Overall, only few trials were considered of low risk of bias for smoking-dependence and obesity, and as such none of the significant effects in favour of acupuncture interventions were robust against potential selection, performance, and detection bias.
CONCLUSIONS
This review found no convincing evidence for effects of acupuncture interventions for improving lifestyle risk factors for stroke.
背景
生活方式危险因素的改变可能有助于预防中风事件。本系统评价旨在确定和总结针灸干预生活方式危险因素的证据，包括酒精依赖、吸烟依赖、高血压和肥胖。
方法
从 1996 年 1 月至 2016 年 12 月，检索 MEDLINE、CINAHL/EBSCO、SCOPUS 和 Cochrane 数据库。仅纳入具有实证研究结果的随机对照试验（RCT）。采用 PRISMA 指南，并使用 Cochrane 协作风险偏倚评估工具评估偏倚风险。本文报告的系统评价已在 PROSPERO 注册（CRD42017060490）。
结果
共有 59 项 RCT（5650 名参与者）研究了针刺治疗中风生活方式危险因素的作用，符合纳入标准。7 项 RCT 重点关注酒精依赖，在干预细节方面存在显著异质性。没有发现针刺与假干预相比在控制血压方面的干预后或长期效果的荟萃分析证据。与假针刺相比，接受耳穴按压治疗吸烟依赖的个体每天吸烟量较少（两项 RCT，平均差异（MD）=-2.75 支/天；95%置信区间（CI）=-5.33，-0.17；p=0.04）。与假针刺相比，接受针刺治疗肥胖的个体报告腰围更小（五项 RCT，MD=-2.79 厘米；95%CI：-4.13，-1.46；p<0.001）。总体而言，仅有少数试验被认为对吸烟依赖和肥胖的偏倚风险较低，因此，针刺干预的显著效果并非对潜在的选择、表现和检测偏倚具有稳健性。
结论
本综述未发现针刺干预改善中风生活方式危险因素的令人信服的证据。
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