School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China,
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Complement Med Res. 2024;31(1):40-55. doi: 10.1159/000534115. Epub 2023 Oct 16.
BACKGROUND: With the increasing prevalence of Tourette syndrome (TS), the search for alternative therapy for TS is a growing public concern. In recent years, a growing number of randomized controlled trials (RCTs) have revealed the value of acupuncture combined with herbal medicine for the treatment of TS; however, its holistic efficacy and safety remains unclear. This study aimed to evaluate the efficacy and safety of acupuncture combined with herbal medicine and to provide preliminary evidence for clinical practice. METHODS: Eight databases were searched from their establishment to November 27, 2022, to collect RCTs of acupuncture combined with herbal medicine for TS treatment. Two researchers independently completed the study screening, data extraction, and risk of bias assessment by using NoteExpress, Excel, and Cochrane Risk of Bias Tool 2.0 (RoB 2.0). Stata 15.0 software was applied to conduct meta-analysis. RESULTS: A total of 1,400 participants in 18 RCTs were included. Compared with the Western medicine, acupuncture combined with herbal medicine had better curative effect in the field of effective rate (risk ratio [RR] = 1.18, 95% CI: [1.12, 1.23], p < 0.05, I2 = 0%), Yale Global Tic Severity Scale (YGTSS) total score (mean difference [MD] = -3.91, 95% CI: [-5.49, -2.33], p < 0.05, I2 = 96.4%), TCM syndrome total score (MD = -2.42, 95% CI: [-3.71, -1.13], p < 0.05, I2 = 87.1%), and serum IgE negative rate (RR = 3.41, 95% CI: [1.69, 6.87], p < 0.05, I2 = 0%). Furthermore, acupuncture combined with herbal medicine reduced the adverse reaction rate (RR = 0.20, 95% CI: [0.14, 0.30], p < 0.05, I2 = 0%) and the recurrence rate (RR = 0.27, 95% CI: [0.13, 0.52], p < 0.05, I2 = 0%). CONCLUSION: This study demonstrated the efficacy and safety of acupuncture combined with herbal medicine, which is probably a better alternative therapy for TS. However, the small number, low quality, and potential bias of the included studies caused the limitations of our results. More high-quality RCTs are required to provide supplementary evidence in the future. UNLABELLED:
背景：随着抽动秽语综合征（TS）的患病率不断上升，寻找替代 TS 的治疗方法已成为公众日益关注的问题。近年来，越来越多的随机对照试验（RCT）揭示了针灸结合草药治疗 TS 的价值；然而，其整体疗效和安全性仍不清楚。本研究旨在评估针灸结合草药的疗效和安全性，并为临床实践提供初步证据。
方法：从建库起至 2022 年 11 月 27 日，我们对 8 个数据库进行了检索，以收集针灸结合草药治疗 TS 的 RCT。两名研究人员使用 NoteExpress、Excel 和 Cochrane 偏倚风险工具 2.0（RoB 2.0）独立完成了研究筛选、数据提取和偏倚风险评估。使用 Stata 15.0 软件进行荟萃分析。
结果：共有 18 项 RCT 的 1400 名参与者被纳入。与西药相比，针灸结合草药在有效率（风险比[RR] = 1.18，95%CI：[1.12，1.23]，p < 0.05，I2 = 0%）、耶鲁整体抽动严重程度量表（YGTSS）总分（均数差[MD] = -3.91，95%CI：[-5.49，-2.33]，p < 0.05，I2 = 96.4%）、中医证候总分（MD = -2.42，95%CI：[-3.71，-1.13]，p < 0.05，I2 = 87.1%）和血清 IgE 阴性率（RR = 3.41，95%CI：[1.69，6.87]，p < 0.05，I2 = 0%）方面均有更好的疗效。此外，针灸结合草药还降低了不良反应发生率（RR = 0.20，95%CI：[0.14，0.30]，p < 0.05，I2 = 0%）和复发率（RR = 0.27，95%CI：[0.13，0.52]，p < 0.05，I2 = 0%）。
结论：本研究表明针灸结合草药具有疗效和安全性，可能是治疗 TS 的一种更好的替代疗法。然而，纳入研究数量较少、质量较低以及潜在的偏倚限制了我们结果的可信度。未来需要更多高质量的 RCT 来提供补充证据。
Complement Med Res. 2024
Complement Med Res. 2023
Zotero 插件