School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China (mainland).
School of Acupuncture and Massage, Guiyang College of Traditional Chinese Medicine, Guiyang, Guizhou, China (mainland).
Med Sci Monit. 2019 Feb 16;25:1263-1274. doi: 10.12659/MSM.913379.
BACKGROUND In traditional Chinese medicine, acupuncture has been used to treat angina due to coronary artery disease (CAD). The aim of this systematic review of the literature and meta-analysis was to identify published randomized controlled trials (RCTs) that quantified the effectiveness of adjunctive acupuncture treatment in patients with angina due to CAD who were also treated with Western or Chinese medicine. MATERIAL AND METHODS A systematic review of the literature included a search of the PubMed, Embase, Cochrane library, and China National Knowledge Infrastructure (CNKI) databases, from their inception to September 2018. Published findings from RCTs were included that investigated the effectiveness of acupuncture as an adjunctive treatment for angina due to CAD in combination with Western or traditional Chinese medicine. The odds ratio (OR) and 95% confidence interval (CI) were calculated using the random-effects model to determine the outcomes of markedly and moderately effective rates for the use of acupuncture. RESULTS Twenty-four published RCTs were identified that included 1,916 patients with CAD. Patients who received adjunctive acupuncture treatment had a significantly increased markedly effective rate. However, the moderately effective rate between adjunctive acupuncture combined with standard treatment for angina and standard treatment alone was not statistically significant. Sensitivity analysis showed that the pooled results for the markedly and moderately effective rates were robust. Subgroup analysis in most subsets supported the main findings. CONCLUSIONS Meta-analysis supported a positive treatment effect for the use of acupuncture when used as adjunctive therapy in patients with angina due to CAD.
在中医中,针灸已被用于治疗因冠状动脉疾病(CAD)引起的心绞痛。本系统评价文献和荟萃分析的目的是确定已发表的随机对照试验(RCT),这些 RCT 量化了在接受中西药物治疗的 CAD 相关心绞痛患者中,辅助性针灸治疗的有效性。
系统检索了 PubMed、Embase、Cochrane 图书馆和中国知网(CNKI)数据库,从建库至 2018 年 9 月,检索有关针灸辅助治疗 CAD 相关心绞痛的有效性的 RCT 研究。采用随机效应模型计算优势比(OR)和 95%置信区间(CI),以确定针灸在显著和中度有效率方面的应用效果。
共纳入 24 项已发表的 RCT,包含 1916 例 CAD 患者。接受辅助性针灸治疗的患者其显著有效率显著提高。然而,辅助性针灸联合标准治疗心绞痛与单纯标准治疗的中度有效率之间无统计学意义。敏感性分析表明,合并后显著和中度有效率的结果是稳健的。大多数亚组的亚组分析均支持主要发现。
荟萃分析支持将针灸作为 CAD 相关心绞痛患者的辅助治疗方法具有积极的治疗效果。