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纤维肌痛的针灸疗法:随机对照试验的系统评价与荟萃分析

Acupuncture therapy for fibromyalgia: a systematic review and meta-analysis of randomized controlled trials.

作者信息

Zhang Xin-Chang, Chen Hao, Xu Wen-Tao, Song Yang-Yang, Gu Ya-Hui, Ni Guang-Xia

机构信息

The Second Clinical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China Email

出版信息

J Pain Res. 2019 Jan 30;12:527-542. doi: 10.2147/JPR.S186227. eCollection 2019.

Abstract

PURPOSE

Fibromyalgia (FM) can cause chronic widespread pain and seriously affect the quality of patient lives. Acupuncture therapy is widely used for pain management. However, the effect of acupuncture on FM is still uncertain. The aim of this review was to determine the effect and safety of acupuncture therapy on the pain intensity and quality of life in patients with FM.

MATERIALS AND METHODS

We searched PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database, and the Chinese Biomedical Literature Database to collect randomized controlled trials (RCTs) of acupuncture for FM published before May 2018. A meta-analysis was performed according to the Cochrane systematic review method by using RevMan 5.3 software, and GRADE was used to evaluate the quality of the evidence.

RESULTS

We identified 12 RCTs that compared acupuncture therapy to sham acupuncture or conventional medication. Meta-analysis showed that acupuncture was significantly better than sham acupuncture for relieving pain (MD =-1.04, 95% CI [-1.70, -0.38], =0.002, =78%) and improving the quality of life (MD =-13.39, 95% CI [-21.69, -5.10], =0.002, =82%), with low- to moderate-quality evidence in the short term. At follow-up in the long term, the effect of acupuncture was also superior to that of sham acupuncture. No serious adverse events were found during acupuncture.

CONCLUSION

Acupuncture therapy is an effective and safe treatment for patients with FM, and this treatment can be recommended for the management of FM.

摘要

目的

纤维肌痛(FM)可导致慢性广泛性疼痛,并严重影响患者生活质量。针灸疗法被广泛用于疼痛管理。然而,针灸对FM的疗效仍不确定。本综述的目的是确定针灸疗法对FM患者疼痛强度及生活质量的疗效和安全性。

材料与方法

我们检索了PubMed、Cochrane图书馆、Embase、中国知网、中国科技期刊数据库和中国生物医学文献数据库,以收集2018年5月之前发表的关于针灸治疗FM的随机对照试验(RCT)。使用RevMan 5.3软件,根据Cochrane系统评价方法进行荟萃分析,并采用GRADE评估证据质量。

结果

我们纳入了12项将针灸疗法与假针灸或传统药物进行比较的RCT。荟萃分析表明,在短期内,针灸在缓解疼痛(MD = -1.04,95%CI [-1.70, -0.38],P = 0.002,I² = 78%)和改善生活质量(MD = -13.39,95%CI [-21.69, -5.10],P = 0.002,I² = 82%)方面显著优于假针灸,证据质量为低到中等质量。在长期随访中,针灸的效果也优于假针灸。针灸过程中未发现严重不良事件。

结论

针灸疗法是一种治疗FM患者有效且安全的方法,可推荐用于FM的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/227c/6365227/3747b2bf6edb/jpr-12-527Fig1.jpg

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