Shandong University of Traditional Chinese Medicine, First Clinical Medical College, Jinan City, Shandong Province, China.
Shandong Provincial Third Hospital, Jinan City, Shandong Province, China.
Medicine (Baltimore). 2024 Nov 29;103(48):e40474. doi: 10.1097/MD.0000000000040474.
To systematically evaluate the efficacy and safety of acupuncture in the treatment of atrial fibrillation (AF).
Eight databases were searched. The search time limit is from January 2000 to November 2023. All randomized controlled trials on acupuncture treatment of AF were included. After the literature screening, data extraction and quality evaluation were carried out independently according to the inclusion and exclusion criteria, and the included literature was analyzed by Meta using RevMan 5.4 software.
A total of 15 research studies on randomized controlled trials were included, involving 1960 patients. The results of the meta-analysis showed that acupuncture therapy could increase the sinus cardioversion rate of patients with AF, and the difference was statistically significant (relative risk = 1.21, 25% confidence interval (CI) [1.11, 1.31], P < .001). The clinically effective rate of the acupuncture plus drug treatment group was higher than that of the drug treatment group (relative risk = 1.32, 95% CI [1.19, 1.46], P < .01). Acupuncture plus other conventional therapies treatment was more helpful in reducing the ventricular rate of patients with AF (mean difference = -7.89, 95% CI [-14.52, -1.26], P = .006). The cardioversion time of patients with AF treated with acupuncture plus conventional therapies was shorter than those treated with traditional therapies alone (standardized mean difference = -1.82, 95% CI [-3.28, -0.35], P = .01). No severe adverse reactions such as hemorrhage, hematoma, or local infection caused by acupuncture were reported in the study.
The available evidence shows that acupuncture can effectively improve the total clinical effective rate and sinus rhythm recovery rate, shorten the recovery time of sinus rhythm, and reduce the ventricular rate, and there are no apparent adverse reactions. However, a limited number of studies may affect the generalizability of the findings. Future studies should include more extensive and diverse studies to enhance the power and generalizability of the findings.
系统评价针灸治疗心房颤动（AF）的疗效和安全性。
检索 8 个数据库。检索时间限定为 2000 年 1 月至 2023 年 11 月。纳入所有针灸治疗 AF 的随机对照试验。文献筛选后，根据纳入和排除标准独立进行数据提取和质量评价，并采用 RevMan 5.4 软件进行 Meta 分析。
共纳入 15 项随机对照试验研究，涉及 1960 例患者。Meta 分析结果显示，针灸疗法可提高 AF 患者的窦性心律转复率，差异有统计学意义（相对危险度=1.21，25%置信区间[1.11，1.31]，P<0.001）。针灸联合药物治疗组的临床有效率高于药物组（相对危险度=1.32，95%置信区间[1.19，1.46]，P<0.01）。针灸联合其他常规疗法治疗更有助于降低 AF 患者的心室率（均数差=-7.89，95%置信区间[-14.52，-1.26]，P=0.006）。联合常规疗法治疗的 AF 患者的转复时间短于单独接受传统疗法的患者（标准化均数差=-1.82，95%置信区间[-3.28，-0.35]，P=0.01）。研究中未报告因针灸引起的出血、血肿或局部感染等严重不良反应。
现有证据表明，针灸可有效提高总临床有效率和窦性节律恢复率，缩短窦性节律恢复时间，降低心室率，且无明显不良反应。但是，由于研究数量有限，可能影响研究结果的推广性。未来的研究应纳入更广泛和多样化的研究，以增强研究结果的说服力和推广性。
