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电针治疗功能性消化不良:一项系统评价与荟萃分析。

Electroacupuncture for the treatment of functional dyspepsia: A systematic review and meta-analysis.

作者信息

Mao Xinyong, Guo Song, Ni Wenchao, Zhang Tao, Liu Qian, Du Sijing, Luo Mengxue, Pan Yuyan, Wu Baoqi, Su Xiaolan, Yang Yang, Guo Yu, Chen Jiande J D, Rong Peijing, Wei Wei

机构信息

Department of Gastroenterology, Beijing Key Laboratory of Functional Gastrointestinal Disorders Diagnosis and Treatment of Traditional Chinese Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences.

Dongzhimen Hospital, Beijing University of Chinese Medicine.

出版信息

Medicine (Baltimore). 2020 Nov 6;99(45):e23014. doi: 10.1097/MD.0000000000023014.

Abstract

BACKGROUND

Functional dyspepsia (FD) is a common functional gastrointestinal disease. Acupuncture, including electroacupuncture (EA) is widely used as a complementary and alternative treatment for patients with FD. This study aimed to explore the effectiveness of EA for the treatment of FD.

METHODS

We searched Embase, PubMed, and the Cochrane Central Register of Controlled Trials (Cochrane Library) for randomized controlled trials of FD treated by EA from inception to February 3, 2020. Two reviewers will independently screen studies for data extraction and assess the quality and risk of bias. The Cochrane Collaboration's risk of bias tool, RevMan 5.3 software were used for meta-analysis. Data were pooled to calculate relative risk and 95% confidence intervals (CIs) of substantial improvement after treatment for dichotomous data and mean differences (SMDs) and 95% CIs for continuous data.

RESULTS

Seven randomized clinical trials included 853 patients. This meta-analysis investigated the effectiveness of EA alone in the treatment of FD relative to sham-EA or pharmacologic medication (PM). The results showed that EA could significantly improve clinical symptoms. Compared with sham-EA, EA was more effective in reducing symptom scores (SMD -3.44, 95% CI -4.21 to -2.67) and increasing normal slow waves of electrogastrogram (SMD 0.93, 95% CI -0.30 to1.55). When EA was combined with PM, there was no significant difference in reducing symptom scores (SMD -0.18, 95% CI -0.51 to 0.16), increasing the effective rate of clinical symptoms (risk ratio 1.04, 95% CI 0.96 to 1.13), enhancing the level of plasma motilin (SMD 0.93, 95% CI -0.30 to1.55), and reducing gastric half-emptying time (SMD 0.02, 95% CI -0.16 to 0.20). The results also showed that there were very few adverse events reported.

CONCLUSION

This meta-analysis suggests that EA is better than the placebo (sham-EA) in treating FD, and the therapeutic effect of EA on FD is equivalent to that of PM on FD. Compared with PM, EA for FD is safer and has fewer adverse reactions. Despite limitations due to the quality and number of the included studies, EA might be used as an effective and safe treatment for FD.

摘要

背景

功能性消化不良(FD)是一种常见的功能性胃肠疾病。针灸,包括电针(EA),被广泛用作FD患者的补充和替代治疗方法。本研究旨在探讨电针对FD的治疗效果。

方法

我们检索了Embase、PubMed和Cochrane对照试验中央注册库(Cochrane图书馆),以查找从开始到2020年2月3日期间用电针治疗FD的随机对照试验。两名 reviewers 将独立筛选研究以进行数据提取,并评估质量和偏倚风险。使用Cochrane协作网的偏倚风险工具、RevMan 5.3软件进行荟萃分析。汇总数据以计算二分数据治疗后显著改善的相对风险和95%置信区间(CIs),以及连续数据的均值差(SMD)和95% CIs。

结果

七项随机临床试验纳入了853例患者。本荟萃分析研究了单独使用电针相对于假电针或药物治疗(PM)治疗FD的有效性。结果表明,电针可显著改善临床症状。与假电针相比,电针在降低症状评分(SMD -3.44,95% CI -4.21至-2.67)和增加胃电图正常慢波方面更有效(SMD 0.93,95% CI -0.30至1.55)。当电针与PM联合使用时,在降低症状评分(SMD -0.18,95% CI -0.51至0.16)、提高临床症状有效率(风险比1.04,95% CI 0.96至1.13)、提高血浆胃动素水平(SMD 0.93,95% CI -0.30至1.55)和缩短胃半排空时间(SMD 0.02,95% CI -0.16至0.20)方面无显著差异。结果还表明,报告的不良事件很少。

结论

本荟萃分析表明,电针在治疗FD方面优于安慰剂(假电针),电针治疗FD的疗效与PM治疗FD的疗效相当。与PM相比,电针治疗FD更安全,不良反应更少。尽管由于纳入研究的质量和数量存在局限性,但电针可能作为FD的一种有效且安全的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d228/7647594/c0d3f2605fcf/medi-99-e23014-g004.jpg

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