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比较针灸与药物治疗贝尔面瘫的疗效:随机对照试验的系统评价和荟萃分析。

Compare the efficacy of acupuncture with drugs in the treatment of Bell's palsy: A systematic review and meta-analysis of RCTs.

作者信息

Zhang Rongchao, Wu Tao, Wang Ruihui, Wang Dong, Liu Qi

机构信息

Acupuncture and Tuina College, Chengdu University of Chinese Medicine, Chengdu, Sichuan.

Shaanxi University of Chinese Medicine, Xi'an-Xianyang New Economic Zone, Shaanxi, China.

出版信息

Medicine (Baltimore). 2019 May;98(19):e15566. doi: 10.1097/MD.0000000000015566.

Abstract

BACKGROUND

Bell's palsy or idiopathic facial paralysis is an acute facial paralysis caused by the inflammation of facial nerve. Several previous studies showed that acupuncture was beneficial in the treatment of facial paralysis. However, its effectiveness is still controversial compared with drug therapy. Therefore, this systematic review and meta-analysis was performed to assess the efficacy of acupuncture for Bell's palsy.

METHODS

This is a systematic review and meta-analysis of clinical studies among patients with Bell's palsy. We did a systematic literature search in PubMed, Embase, and the Cochrane Register of Controlled Trials to identify studies comparing the efficacy of acupuncture and drug treatment in treating facial paralysis. The search was last updated on July 2018.

RESULTS

The study included 11 randomized controlled trials with an overall sample of 1258 individuals. Acupuncture treatment was associated with an increased cure rate [relative risk (RR) = 1.77, 95% confidence interval (CI): 1.41-2.21], with significant heterogeneity in the pooled results (I = 67%, P = .0008). There was a significant difference in total effective rate in acupuncture and drug treatment for Bell's palsy (RR = 1.18,95% CI: 1.07-1.31), with substantial heterogeneity (I = 90%, P < .00001).

CONCLUSION

Although there was not enough evidence to prove its safety, acupuncture seems to be an effective therapy for Bell's palsy. Results of the present meta-analysis showed that acupuncture was associated with increased cure rate and total effective rate of the treatment of Bell's palsy in comparison with drugs. However, the results should be interpreted cautiously, because of the poor quality and heterogeneity of the included studies. In the future, more and more high quality randomized controlled trials (RCT) are needed to prove the safety and effectiveness of acupuncture.

摘要

背景

贝尔氏面瘫或特发性面神经麻痹是一种由面神经炎症引起的急性面瘫。先前的多项研究表明,针灸对面瘫治疗有益。然而,与药物治疗相比,其有效性仍存在争议。因此,进行了这项系统评价和荟萃分析,以评估针灸治疗贝尔氏面瘫的疗效。

方法

这是一项针对贝尔氏面瘫患者临床研究的系统评价和荟萃分析。我们在PubMed、Embase和Cochrane对照试验注册库中进行了系统的文献检索,以识别比较针灸和药物治疗面瘫疗效的研究。检索的最后更新时间为2018年7月。

结果

该研究纳入了11项随机对照试验,总样本量为1258人。针灸治疗与治愈率提高相关[相对危险度(RR)=1.77,95%置信区间(CI):1.41-2.21],汇总结果存在显著异质性(I=67%,P=0.0008)。贝尔氏面瘫的针灸和药物治疗总有效率存在显著差异(RR=1.18,95%CI:1.07-1.31),异质性较大(I=90%,P<0.00001)。

结论

虽然没有足够的证据证明其安全性,但针灸似乎是治疗贝尔氏面瘫的有效疗法。本荟萃分析结果表明,与药物相比,针灸可提高贝尔氏面瘫治疗的治愈率和总有效率。然而,由于纳入研究的质量较差且存在异质性,这些结果应谨慎解读。未来,需要越来越多高质量的随机对照试验(RCT)来证明针灸的安全性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc8/6531040/c26f31f69738/medi-98-e15566-g001.jpg

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