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[针灸治疗精神分裂症的Meta分析]

[A Meta-analysis on Acupuncture and Moxibustion Treatment of Schizophrenia].

作者信息

Zhao Jun-Qiao, Ma Tie-Ming

机构信息

School of Acupuncture-moxibustion and Tuina, Liaoning University of Traditional Chinese Medicine, Shenyang 110032, China.

出版信息

Zhen Ci Yan Jiu. 2018 Dec 25;43(12):806-12. doi: 10.13702/j.1000-0607.170716.

Abstract

OBJECTIVE

To evaluate the clinical efficacy and security of acupuncture therapy combined with conventional antipsychotics in the treatment of schizophrenia.

METHODS

We first comprehensively retrieved papers about acupuncture or moxibustion treatment of schizophrenia published from the time of establishment of the database to April of 2017 in Chinese databases such as Chinese National Knowledge Infrastructure(CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang, and Chinese BioMedical Literature (CBM) by using keywords "acupuncture""moxibustion""acupuncture +moxibustion""acupuncture +medication""electroacupuncture""filiform needle""scalp-acupuncture""auricular acupuncture", etc. Then, according to the principles and methods of evidence-based medicine, papers conformed to the included standards were enrolled to Meta-analysis by using Review Manager 5.3 software.

RESULTS

A total of 618 studies were identified, with only 17 articles (containing 1 542 patients) conformed to our included standards and analyzed finally. In regard to the total effective rate of acupuncture or moxibustion for schizophrenia, the combined OR=3.09, 95% CI (2.31, 4.13), the diamond was on the right side of the vertical line (suggesting being effective), OR checked by test (=7.61, <0.000 01). In regard to the untoward effect, the combined OR=0.34, 95% CI (0.16, 0.75), the diamond was on the left side of the vertical line (suggesting less adverse effects), OR checked by test (=2.67,=0.008). Sensitivity analysis: the combined standardized mean difference (SMD)=-0.61, 95% CI(-0.88, -0.34), the diamond was on the left side of the vertical line (suggesting having more profits than simple medication), SMD checked by test (=4.39, <0.000 1)..

CONCLUSION

Acupuncture and moxibustion combined with conventional antipsychotics is significantly better than that of antipsychotics alone in the treatment of schizophrenia and has less side effects. But, high quality clinical studies with rigorous experimental design and large sample size are needed to provide more reliable evidence.

摘要

目的

评价针刺疗法联合传统抗精神病药物治疗精神分裂症的临床疗效与安全性。

方法

首先通过使用关键词“针刺”“艾灸”“针刺+艾灸”“针刺+药物”“电针”“毫针”“头皮针”“耳针”等,在中国知网(CNKI)、维普中文科技期刊数据库(VIP)、万方、中国生物医学文献数据库(CBM)等中文数据库中全面检索自建库至2017年4月发表的有关针刺或艾灸治疗精神分裂症的文献。然后,按照循证医学的原则和方法,将符合纳入标准的文献采用Review Manager 5.3软件进行Meta分析。

结果

共检索到618项研究,最终仅17篇文章(含1542例患者)符合纳入标准并进行分析。针刺或艾灸治疗精神分裂症的总有效率方面,合并OR=3.09,95%CI(2.31,4.13),菱形位于垂直线右侧(提示有效),经检验OR=7.61,P<0.000 01。不良反应方面,合并OR=0.34,95%CI(0.16,0.75),菱形位于垂直线左侧(提示不良反应较少),经检验OR=2.67,P=0.008。敏感性分析:合并标准化均数差(SMD)=-0.61,95%CI(-0.88,-0.34),菱形位于垂直线左侧(提示比单纯药物治疗获益更多),经检验SMD=4.39,P<0.000 1。

结论

针刺艾灸联合传统抗精神病药物治疗精神分裂症的疗效显著优于单纯使用抗精神病药物,且副作用较少。但是,需要高质量、设计严谨、大样本量临床研究提供更可靠的证据。

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