Song Yan-Juan, Liang Feng-Xia, Wu Song, Yang Hui-Sheng, Chen Li, Huang Qi, Tang Hong-Tu, Lu Wei, Wang Hua, Chen Song, Zhang Yan-Ji, Zhang Yan-Lin
College of Acupuncture and Orthopedics, Hubei University of CM/Collaborative Innovation Center for Acupuncture and Moxibustion, Wuhan 430061, China.
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences.
Zhongguo Zhen Jiu. 2019 Jul 12;39(7):792-8. doi: 10.13703/j.0255-2930.2019.07.029.
To review systematically the safety and effectiveness of acupuncture-related therapies on ovulation rate and pregnancy rate in patients with polycystic ovary syndrome (PCOS).
From PubMed, EMbase, the Cochrane Library, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), Wanfang database and VIP database, the randomized controlled trials (RCTs) on PCOS were retrieved in the period from the date of database establishment to January 8, 2018. Two researchers screened the articles, extracted the data and assessed the bias risk of the eligible trials independently. Using Stata 13.0 and WinBUGS 1.4.3 software, the data were analyzed.
A total of 39 RCTs were collected, including 4605 cases of PCOS and 14 kinds of acupuncture-related therapies and the comprehensive therapies. The short-term therapeutic effects were observed. The results of mesh meta-analysis showed: regarding the ovulation rate, the effects of the acupuncture-medication therapy were better than western medication. The top 6 therapeutic measures were the treatment with acupoint thread-embedding therapy and medication (93.3%), the treatment with moxibustion and Chinese herbal medicine (91.4%), moxibustion (74.5%), the treatment with acupuncture and medication (65.7%), the treatment with acupuncture-moxibustion and auricular point therapy (61.9%) and the treatment with acupuncture and auricular point therapy (49.6%). Regarding the pregnancy rate, the effects of the acupuncture-medication therapy were better than western medication. The top 6 therapeutic measures were the treatment with acupuncture and auricular point therapy (91.5%), the treatment with moxibustion and Chinese herbal medication (86.9%), the treatment with acupuncture-moxibustion and auricular point therapy (81.1%), the treatment with acupoint thread-embedding therapy and medication (69.4%), the treatment with acupuncture and medication (66.1%) and the treatment with placebo and western medication (58.7%).
Among acupuncture-related therapies, the combined treatment is more advantageous than single therapy and its safety is superior to western medication. The combined therapies are various in advantages. Because of the limitation of the present researches, it needs a large scale of RCTs with rational design, high quality and proper methods to verify this research conclusion.
系统评价针刺相关疗法对多囊卵巢综合征（PCOS）患者排卵率及妊娠率的安全性和有效性。
通过检索PubMed、EMbase、Cochrane图书馆、中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据库及维普数据库，收集自建库至2018年1月8日期间关于PCOS的随机对照试验（RCT）。由两名研究者独立筛选文献、提取数据并评估纳入试验的偏倚风险。采用Stata 13.0和WinBUGS 1.4.3软件进行数据分析。
共纳入39项RCT，涉及4605例PCOS患者，14种针刺相关疗法及综合疗法，观察其短期治疗效果。网状Meta分析结果显示：在排卵率方面，针药结合疗法效果优于单纯西药。前6位治疗措施依次为穴位埋线配合药物治疗（93.3%）、艾灸配合中药治疗（91.4%）、艾灸治疗（74.5%）、针刺配合药物治疗（65.7%）、针艾灸配合耳穴疗法（61.9%）、针刺配合耳穴疗法（49.6%）。在妊娠率方面，针药结合疗法效果优于单纯西药。前6位治疗措施依次为针刺配合耳穴疗法（91.5%）、艾灸配合中药治疗（86.9%）、针艾灸配合耳穴疗法（81.1%）、穴位埋线配合药物治疗（69.4%）、针刺配合药物治疗（66.1%）、安慰剂配合西药治疗（58.7%）。
在针刺相关疗法中，联合治疗比单一疗法更具优势，且安全性优于西药。联合疗法各有优势。鉴于目前研究的局限性，需要开展更多设计合理、质量高、方法恰当的大样本RCT来验证本研究结论。
