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针刺治疗功能性消化不良决策证据的可靠性。

Reliability of the Evidence to Guide Decision-Making in Acupuncture for Functional Dyspepsia.

机构信息

Department of Gastroenterology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Department of Gastroenterology, Peking University Traditional Chinese Medicine Clinical Medical School (Xiyuan), Beijing, China.

出版信息

Front Public Health. 2022 Apr 1;10:842096. doi: 10.3389/fpubh.2022.842096. eCollection 2022.


DOI:10.3389/fpubh.2022.842096
PMID:35433619
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9010971/
Abstract

BACKGROUND AND AIMS: There has been a significant increase in the number of systematic reviews (SRs)/meta-analyses (MAs) investigating the effects of acupuncture for functional dyspepsia (FD). To systematically collate, appraise, and synthesize the current evidence, we carried out an umbrella review of SRs/MAs. METHODS: Systemic reviews/meta-analyses on acupuncture for FD were collected by searching major medical databases. The included studies were evaluated in terms of methodological quality, reporting quality, and evidence quality using the criteria from the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system, respectively. RESULTS: Ten SRs/MAs were analyzed for this study. The methodological quality, reporting quality, and evidence quality of the included SRs/MAs were generally unsatisfactory. Lack of protocol registration, no list of excluded trials, or lack of a comprehensive search strategy were the main limitations. No high-quality evidence was found to support the effects of acupuncture for FD; the qualitative data synthesis relied on low quality trials with small sample sizes and was the main factor for evidence degradation. CONCLUSIONS: Acupuncture seems to have a promising efficacy in the treatment of FD. It provides a new and prospective therapeutic method for FD. Although the quality of the included SRs/MAs was generally low and defects were frequent, this umbrella review highlights areas where improvement in methodology is required.

摘要

背景与目的:针对功能性消化不良(FD)的针灸疗效进行系统评价/荟萃分析(SR/MA)的数量显著增加。为了系统地收集、评估和综合当前证据,我们对 SR/MA 进行了伞式评价。

方法:通过检索主要医学数据库收集了关于针灸治疗 FD 的 SR/MA。使用评估多个系统评价 2(AMSTAR-2)工具、系统评价和荟萃分析的首选报告项目(PRISMA)声明以及推荐分级评估、制定与评价(GRADE)系统的标准,分别评估纳入研究的方法学质量、报告质量和证据质量。

结果:本研究分析了 10 篇 SR/MA。纳入的 SR/MA 的方法学质量、报告质量和证据质量普遍不理想。主要限制因素包括:未进行方案注册、未列出排除试验或未进行全面的搜索策略。没有高质量的证据支持针灸治疗 FD 的疗效;定性数据综合依赖于样本量小且质量低的试验,是证据降级的主要因素。

结论:针灸似乎对 FD 有较好的疗效,为 FD 提供了一种新的有前景的治疗方法。尽管纳入的 SR/MA 质量普遍较低且缺陷频繁,但本次伞式评价强调了需要改进方法学的领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d16/9010971/305c104edfd8/fpubh-10-842096-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d16/9010971/cffaf7f6bdb0/fpubh-10-842096-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d16/9010971/980339190f14/fpubh-10-842096-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d16/9010971/305c104edfd8/fpubh-10-842096-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d16/9010971/cffaf7f6bdb0/fpubh-10-842096-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d16/9010971/980339190f14/fpubh-10-842096-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d16/9010971/305c104edfd8/fpubh-10-842096-g0003.jpg

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本文引用的文献

[1]
Electroacupuncture for the treatment of functional dyspepsia: A systematic review and meta-analysis.

Medicine (Baltimore). 2020-11-6

[2]
A Critical Overview of Systematic Reviews and Meta-Analyses on Acupuncture for Poststroke Insomnia.

Evid Based Complement Alternat Med. 2020-10-9

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Aliment Pharmacol Ther. 2019-3-28

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Cultural Factors Influencing Functional Gastrointestinal Disorders in the East.

J Neurogastroenterol Motil. 2018-10-1

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BMJ. 2017-9-21

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Acupuncture for Functional Dyspepsia: What Strength Does It Have? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Evid Based Complement Alternat Med. 2016

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JACC Cardiovasc Interv. 2016-11-14

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Gastroduodenal Disorders.

Gastroenterology. 2016-5

[9]
Efficacy and Safety of Acupuncture for the Treatment of Functional Dyspepsia: Meta-Analysis.

J Altern Complement Med. 2016-5

[10]
Efficacy of acupuncture treatment for functional dyspepsia: A systematic review and meta-analysis.

Complement Ther Med. 2015-12

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