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电针对急性痛风性关节炎的疗效:一项随机对照试验的系统评价和荟萃分析。

Electroacupuncture for acute gouty arthritis: a systematic review and meta-analysis of randomized controlled trials.

机构信息

College of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

West China Second University Hospital, Sichuan University, Chengdu, China.

出版信息

Front Immunol. 2024 Jan 4;14:1295154. doi: 10.3389/fimmu.2023.1295154. eCollection 2023.

Abstract

UNLABELLED

Acute gouty arthritis (AGA) is a metabolic disorder in which recurrent pain episodes can severely affect the quality of life of gout sufferers. Electroacupuncture (EA) is a non-pharmacologic therapy. This systematic review aimed to assess the efficacy and safety of electroacupuncture in treating acute gouty arthritis. We searched eight Chinese and English databases from inception to July 30, 2023, and 242 studies were retrieved. Finally, 15 randomized controlled trials (n=1076) were included in a meta-analysis using Review Manager V.5.4.1. meta-analysis results included efficacy rate, visual rating scale (VAS) for pain, serum uric acid level (SUA), immediate analgesic effect, and incidence of adverse events. Electroacupuncture (or combined non-pharmacologic) treatment of AGA was significantly different from treatment with conventional medications (RR = 1.14, 95% confidence interval CI = 1.10 to 1.19, P < 0.00001). The analgesic effect of the electroacupuncture group was superior to that of conventional Western drug treatment (MD = -2.26, 95% CI = -2.71 to -1.81, P < 0.00001). The electroacupuncture group was better at lowering serum uric acid than the conventional western drug group (MD =-31.60, CI -44.24 to -18.96], P < 0.00001). In addition, electroacupuncture combined with Western drugs had better immediate analgesic effects than conventional Western drug treatment (MD = -1.85, CI -2.65 to -1.05, P < 0.00001). Five studies reported adverse events in the electroacupuncture group versus the drug group, including 19 cases of gastrointestinal symptoms and 6 cases of neurological symptoms (RR = 0.20, 95% CI = 0.04 to 0.88, P = 0.03).

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=450037, identifier CRD42023450037.

摘要

背景:急性痛风性关节炎(AGA)是一种代谢紊乱性疾病,其反复发作的疼痛会严重影响痛风患者的生活质量。电针(EA)是一种非药物疗法。本系统评价旨在评估电针对急性痛风性关节炎的疗效和安全性。我们检索了 8 个中文和英文数据库,检索时间截至 2023 年 7 月 30 日,共检索到 242 项研究。最终,使用 Review Manager V.5.4.1 对 15 项随机对照试验(n=1076)进行了荟萃分析。meta 分析结果包括有效率、视觉模拟评分(VAS)疼痛评分、血清尿酸水平(SUA)、即刻镇痛效果和不良反应发生率。AGA 的电针(或联合非药物)治疗与常规药物治疗有显著差异(RR=1.14,95%置信区间 CI=1.10 至 1.19,P<0.00001)。电针组的镇痛效果优于常规西药治疗(MD=-2.26,95% CI=-2.71 至-1.81,P<0.00001)。电针组降低血清尿酸的效果优于常规西药组(MD=-31.60,CI=-44.24 至-18.96],P<0.00001)。此外,电针联合西药的即时镇痛效果优于常规西药治疗(MD=-1.85,CI=-2.65 至-1.05,P<0.00001)。五项研究报告了电针组与药物组的不良反应,包括胃肠道症状 19 例和神经症状 6 例(RR=0.20,95% CI=0.04 至 0.88,P=0.03)。

系统评价注册https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=450037,标识符 CRD42023450037。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a0d/10794621/b30af5f223b3/fimmu-14-1295154-g001.jpg

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