Chun Liu, Li Xuanlin, Feng Zhenzhen, Xie Yang, Li Jiansheng
Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, 200030, People's Republic of China.
Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, People's Republic of China.
Int J Gen Med. 2021 Mar 25;14:1079-1092. doi: 10.2147/IJGM.S300270. eCollection 2021.
Since consistent evidence on the effectiveness of acupuncture in the treatment of chronic obstructive pulmonary disease (COPD) is not available, this overview aims to summarize and critically evaluate the methodological and evidence quality of systematic reviews (SRs) on this topic.
Eight electronic databases were searched to identify relevant SRs of the use of acupuncture in the treatment of COPD from inception to January 2021. Two researchers independently screened the literature, extracted the data, and cross-checked the data. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) list was used to assess the methodological quality of SRs. The Grades of Recommendations, Assessment, Development and Evaluation (GRADE) system was used to assess the quality of evidence for the outcomes of interest.
Nine SRs that conducted quantitative syntheses were included in this overview. The methodological quality of the SRs and the quality of evidence for the main outcome measures were generally unsatisfactory. Only 2 SRs were rated as low methodological quality by AMSTAR 2, and the remaining SRs were rated as critically low quality. The key limitations of the SRs were lack of a protocol and registration or a list of excluded studies. We did not find high-quality evidence to confirm the effectiveness of acupuncture for COPD, and the main reason was that the qualitative data synthesis relied on trials with small sample sizes and critically low quality.
Acupuncture appears to be an effective therapeutic method for COPD, but the credibility of the results is limited owing to the generally low methodological quality and evidence quality of the included SRs. Further rigorous and comprehensive studies are required to provide robust evidence and draw definitive conclusions.
由于缺乏关于针灸治疗慢性阻塞性肺疾病（COPD）有效性的一致证据，本综述旨在总结并批判性评估关于该主题的系统评价（SR）的方法学和证据质量。
检索了八个电子数据库，以识别从开始到2021年1月期间使用针灸治疗COPD的相关SR。两名研究人员独立筛选文献、提取数据并交叉核对数据。使用系统评价方法学质量评估2（AMSTAR 2）清单来评估SR的方法学质量。使用推荐分级、评估、制定与评价（GRADE）系统来评估感兴趣结局的证据质量。
本综述纳入了九项进行定量综合分析的SR。SR的方法学质量和主要结局指标的证据质量总体上不尽人意。只有两项SR被AMSTAR 2评为方法学质量低，其余SR被评为极低质量。SR的关键局限性在于缺乏方案和注册信息或排除研究清单。我们未找到高质量证据来证实针灸对COPD的有效性，主要原因是定性数据综合分析依赖于样本量小且质量极低的试验。
针灸似乎是治疗COPD的一种有效治疗方法，但由于所纳入SR的方法学质量和证据质量普遍较低，结果的可信度有限。需要进一步进行严谨且全面的研究以提供有力证据并得出明确结论。
