Anhui Medical University, No. 81 MeiShan Road, Hefei, AnHui, People's Republic of China.
Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230032, Anhui, People's Republic of China.
Complement Ther Med. 2019 Feb;42:381-388. doi: 10.1016/j.ctim.2018.12.009. Epub 2018 Dec 21.
Acupuncture as an alternative treatment method is widely used in the treatment of sudden sensorineural hearing loss(SSNHL) in China. We performed a systematic review and meta-analysis to assess the clinical efficacy of acupuncture for the management of SSNHL patients.
The PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure and WanFang databases were searched. Searches were performed on April 27, 2018 and without language and publication year restrictions. We collected and analyzed the randomized controlled trials (RCTs) of acupuncture for the treatment of SSNHL patients to assess its efficacy and safety. The RevMan5.3 software was used for analysis. The fixed-effects model can be applied to calculate the risk ratio (RR) or weighted mean difference (WMD) if the chi-square test shows there was no significance of heterogeneity (p > 0.10, I<50%). Otherwise, the random effects mode was used.
Twenty randomized controlled trials met our inclusion criteria. The electroacupuncture(EA), manual acupuncture(MA) plus western medicine(WM) and EA plus WM groups lead to significantly better pure tone audiometry(PTA) than WM alone in cured rate (P = 0.01; P < 00,001; P < 0.006, respectively). However, no significant differences were observed between MA and WM (p = 0.27). In terms of total effective rate, all of them showed significant improvement compared to WM alone (MA: P = 0.03; EA: P = 0.01; MA + WM: P < 0.00001; EA + WM: P = 0.04). In addition, no significant difference was found between the MA plus WM and WM alone groups in the improvement of tinnitus (P = 0.37). No trials reported serious adverse events.
Acupuncture could be a valid treatment option for SSNHL, especially for patients who could not be cured by drugs alone. However, the outcome was limited temporarily due to the lack of high-quality research support. High-quality evidence is needed to clarify the future efficacy and safety of acupuncture for SSNHL.
在中国，针灸作为一种替代疗法被广泛应用于突发性聋的治疗。我们进行了一项系统评价和荟萃分析，以评估针灸治疗突发性聋患者的临床疗效。
检索 PubMed、EMBASE、Cochrane 图书馆、中国知网和万方数据库。检索日期为 2018 年 4 月 27 日，无语言和出版年限限制。我们收集和分析了针灸治疗突发性聋患者的随机对照试验（RCTs），以评估其疗效和安全性。采用 RevMan5.3 软件进行分析。如果 chi-square 检验显示异质性无显著性（p>0.10，I<50%），则采用固定效应模型计算风险比（RR）或加权均数差（WMD）。否则，采用随机效应模型。
共有 20 项 RCT 符合纳入标准。电针（EA）、手针（MA）联合西药（WM）和 EA 联合 WM 组在治愈率方面明显优于 WM 单独治疗（P=0.01；P<0.001；P<0.006）。然而，MA 与 WM 之间无显著差异（p=0.27）。在总有效率方面，与 WM 单独治疗相比，所有组均有显著改善（MA：P=0.03；EA：P=0.01；MA+WM：P<0.00001；EA+WM：P=0.04）。此外，MA+WM 组与 WM 单独治疗组在耳鸣改善方面无显著差异（P=0.37）。没有试验报告严重不良事件。
针灸可能是突发性聋的有效治疗选择，特别是对于那些不能单独用药物治愈的患者。然而，由于缺乏高质量的研究支持，结果暂时受到限制。需要高质量的证据来明确针灸治疗突发性聋的未来疗效和安全性。
