Li Ruo-Qi, Wan Li, Zi Ming-Jie, Duan Wen-Hui, He Li-Yun, Gao Rong-Rong
Graduate School of Bejing University of CM, Beijing 100029, China; Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091.
Graduate School of Bejing University of CM, Beijing 100029, China; Guang'anmen Hospital, China Academy of Chinese Medical Sciences.
Zhongguo Zhen Jiu. 2022 Dec 12;42(12):1431-8. doi: 10.13703/j.0255-2930.20220513-0002.
To compare the clinical efficacy among different acupuncture and moxibustion therapies on stable angina pectoris (SAP) of coronary heart disease by means of network Meta-analysis. The articles of randomized controlled trial (RCT) for SAP of coronary heart disease treated with acupuncture and moxibustion therapies were searched from PubMed, Web of Science, Cochrane Library, CNKI, Wanfang database and VIP database from May 1, 2002 to May 1, 2022. The quality of them was assessed with the risk of bias assessment tool of Cochrane 5.3, and the network Meta-analysis was undertaken with Stata 13.1 software. A total of 29 articles were included with the acupuncture and moxibustion therapies involved, e.g. acupuncture, acupoint application and moxibustion. In comparison with the simple routine western medication, the effective rate was better on SAP treated with the combined treatments, in which, acupoint application, moxibustion, acupuncture and intradermal needling were combined with routine western medication (<0.05). Of those combined treatments, the combination of the acupoint application with routine western medication had high probability, suggesting the optimal regimen (area under the curve [SUCRA]=0.711, <0.05). The effective rate of acupuncture combined with routine western medication for ECG improvement was better than that of routine western medication (<0.05), and such combined treatment was high in probability, underlying its optimal treatment (SUCRA=0.800, <0.05). Combined with routine western medication, acupuncture, acupoint application, moxibustion and intradermal needling all improve the clinical efficacy on SAP of coronary heart disease. But, with different outcomes considered, the optimal treatments may be different. It needs more multi-central and large-sample randomized controlled trials to validate these results.
通过网状Meta分析比较不同针灸疗法治疗冠心病稳定型心绞痛（SAP）的临床疗效。检索2002年5月1日至2022年5月1日期间发表在PubMed、Web of Science、Cochrane图书馆、中国知网、万方数据库和维普数据库中关于针灸疗法治疗冠心病SAP的随机对照试验（RCT）文献。采用Cochrane 5.3偏倚风险评估工具对纳入文献进行质量评估，并用Stata 13.1软件进行网状Meta分析。共纳入29篇涉及针灸疗法（如针刺、穴位贴敷、艾灸）的文献。与单纯常规西药相比，联合治疗（穴位贴敷、艾灸、针刺、皮内针联合常规西药）治疗SAP的有效率更高（P<0.05）。在这些联合治疗中，穴位贴敷联合常规西药的概率较高，提示为最佳治疗方案（曲线下面积[SUCRA]=0.711，P<0.05）。针刺联合常规西药改善心电图的有效率优于常规西药（P<0.05），且该联合治疗概率较高，提示为最佳治疗方案（SUCRA=0.800，P<0.05）。针刺、穴位贴敷、艾灸、皮内针联合常规西药均能提高冠心病SAP的临床疗效。但考虑不同结局时，最佳治疗方案可能不同。需要更多多中心、大样本随机对照试验来验证这些结果。
