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针灸治疗耳鸣:随机对照试验的系统评价与荟萃分析

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

作者信息

Huang Kaiyu, Liang Shuang, Chen Lei, Grellet Antoine

机构信息

Department of Acupuncture, Ningbo Municipal Hospital of TCM, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China.

The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China.

出版信息

Acupunct Med. 2021 Aug;39(4):264-271. doi: 10.1177/0964528420938380. Epub 2020 Aug 10.

DOI:10.1177/0964528420938380
PMID:32772848
Abstract

OBJECTIVE

To evaluate the efficacy/effectiveness of acupuncture for the treatment of tinnitus.

METHODS

Four English and four Chinese databases were searched for randomized controlled trials (RCTs) of acupuncture for tinnitus published before 30 September 2018. RCTs applying acupuncture alone compared with conventional treatments, sham acupuncture, or no treatment, as well as acupuncture plus conventional treatments compared with conventional treatments alone, were included. The primary outcome was the visual analogue scale (VAS). Secondary outcomes included tinnitus handicap inventory (THI) and tinnitus severity index (TSI) scores. Meta-analysis was conducted using RevMan V5.3 software. The protocol was registered in the PROSPERO database (ref. CRD42018108692).

RESULTS

Eight studies involving 504 participants were included. Meta-analysis showed no significant differences in the VAS score (mean difference (MD) = -1.81, 95% confidence interval (CI) = -3.69 to 0.07;  = 0.06) between the acupuncture and control groups. However, favorable effects of acupuncture on changes in THI score (MD = -10.11, 95% CI = -12.74 to -7.48;   0.001) and TSI score (MD = -8.36, 95% CI = -8.87 to -7.86;   0.001) were found.

CONCLUSION

Acupuncture had no significant effect on the primary outcome of VAS score compared with control treatment; however, positive effects on secondary outcomes (THI and TSI score) were observed in acupuncture versus control groups. Due to the low quality and small sample size of the included trials, the level of evidence was insufficient to draw any definitive conclusions. Further rigorous and high-quality studies with larger sample sizes should be conducted to confirm the efficacy/effectiveness of acupuncture for tinnitus.

摘要

目的

评估针刺治疗耳鸣的疗效。

方法

检索了四个英文数据库和四个中文数据库,以查找2018年9月30日前发表的针刺治疗耳鸣的随机对照试验(RCT)。纳入了单独应用针刺与传统治疗、假针刺或不治疗进行比较的RCT,以及针刺联合传统治疗与单纯传统治疗进行比较的RCT。主要结局指标为视觉模拟量表(VAS)。次要结局指标包括耳鸣障碍量表(THI)和耳鸣严重程度指数(TSI)评分。使用RevMan V5.3软件进行荟萃分析。该方案已在PROSPERO数据库中注册(参考文献CRD42018108692)。

结果

纳入了八项研究,共504名参与者。荟萃分析显示,针刺组与对照组之间的VAS评分无显著差异(平均差(MD)=-1.81,95%置信区间(CI)=-3.69至0.07;P=0.06)。然而,发现针刺对THI评分变化(MD=-10.11,95%CI=-12.74至-7.48;P<0.001)和TSI评分变化(MD=-8.36,95%CI=-8.87至-7.86;P<0.001)有良好效果。

结论

与对照治疗相比,针刺对VAS评分这一主要结局指标无显著影响;然而,针刺组与对照组相比,对次要结局指标(THI和TSI评分)有积极效果。由于纳入试验的质量较低且样本量较小,证据水平不足以得出任何明确结论。应进行进一步严格且高质量、大样本量的研究,以证实针刺治疗耳鸣的疗效。

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