非药物中医联合传统疗法治疗纤维肌痛的有效性：一项系统评价与Meta分析
Effectiveness of non-pharmacological traditional Chinese medicine combined with conventional therapy in treating fibromyalgia: a systematic review and meta-analysis.
作者信息
Cai Lili, Chen Zhengquan, Liang Juping, Song Yuanyuan, Yu Hong, Zhu Jiaye, Wu Qikai, Zhou Xuan, Du Qing
机构信息
Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Front Neurosci. 2023 Jun 1;17:1097475. doi: 10.3389/fnins.2023.1097475. eCollection 2023.
OBJECTIVE
Fibromyalgia is a chronic musculoskeletal disorder characterized by generalized pain, which is also known as "muscular rheumatism" in Chinese medicine. We undertook this systematic review to evaluate the effectiveness of non-pharmacological traditional Chinese medicine (TCM) combined with conventional therapy on pain, health status, depression, and the quality of life of fibromyalgia patients.
METHODS
Studies were retrieved from five electronic databases (PubMed, the Cumulative Index to Nursing and Allied Health, Cochrane Library, Embase, and Web of Science) with publication date up to August 2022. We included randomized controlled trials examining the effects of a combination of non-pharmacological TCM and conventional therapy on pain intensity, health status, depression, and quality of life.
RESULTS
Four randomized controlled trials with 384 fibromyalgia patients met the inclusion criteria. Results of the meta-analysis showed that non-pharmacological TCM combined with conventional therapy exerted significant positive effects on alleviating pain at the post-intervention time point than conventional therapy only (visual analog scale WMD = -1.410, < 0.01; pressure pain threshold WMD = 0.830, < 0.001, respectively). Significant differences in pain assessment were also observed between the two groups after a long-term follow-up (12 months) (WMD = -1.040 and WMD= 0.380, all < 0.05). The combination therapy group also showed a greater reduction in fibromyalgia impact questionnaire than the control group after a long-term follow-up (WMD = -6.690, < 0.05). Depression and pain-related quality of life showed no difference between groups (all > 0.05).
CONCLUSION
Non-pharmacological TCM combined with conventional therapy may be more effective in alleviating pain and improving health status than conventional therapy only. However, it remains some concerns over the safety and clinic application.
SYSTEMATIC REVIEW REGISTRATION
Identifier: CRD42022352991.
目的
纤维肌痛是一种以全身疼痛为特征的慢性肌肉骨骼疾病，在中医中也被称为“肌肉风湿病”。我们进行这项系统评价，以评估非药物中医联合传统疗法对纤维肌痛患者疼痛、健康状况、抑郁及生活质量的有效性。
方法
从五个电子数据库（PubMed、护理及相关健康累积索引、Cochrane图书馆、Embase和科学网）检索截至2022年8月发表的研究。我们纳入了考察非药物中医与传统疗法联合应用对疼痛强度、健康状况、抑郁及生活质量影响的随机对照试验。
结果
四项涉及384例纤维肌痛患者的随机对照试验符合纳入标准。荟萃分析结果显示，非药物中医联合传统疗法在干预后时间点比单纯传统疗法在减轻疼痛方面有显著积极效果（视觉模拟量表加权均数差=-1.410，P<0.01；压力疼痛阈值加权均数差=0.830，P<0.001）。长期随访（12个月）后，两组在疼痛评估方面也存在显著差异（加权均数差=-1.040和加权均数差=0.380，均P<0.05）。长期随访后，联合治疗组在纤维肌痛影响问卷方面的降低幅度也大于对照组（加权均数差=-6.690，P<0.05）。抑郁及与疼痛相关的生活质量在两组间无差异（均P>0.05）。
结论
非药物中医联合传统疗法在减轻疼痛和改善健康状况方面可能比单纯传统疗法更有效。然而，在安全性和临床应用方面仍存在一些担忧。
系统评价注册
标识符：CRD42022352991。
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