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针灸治疗梅尼埃病的疗效与安全性:一项系统评价与Meta分析

Efficacy and safety of acupuncture in the treatment of Meniere's disease: a systematic review and meta-analysis.

作者信息

Tang Mingjie, Li Yinghong, Lu Man, Zhang Tianchen, Ge Yanhao, Han Jie, Tang Jiqin, Chen Zhaoming

机构信息

Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.

Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.

出版信息

Front Med (Lausanne). 2024 Dec 11;11:1463821. doi: 10.3389/fmed.2024.1463821. eCollection 2024.

Abstract

BACKGROUND

Meniere's disease (MD) is an idiopathic chronic inner ear disease that seriously impacts patients' physical and mental health. Medications may be effective for a proportion of patients, and additional effective treatments are still needed. This review aimed to evaluate the efficacy of acupuncture treatment for MD.

METHODS

Eight databases were systematically searched from their inception to June 1, 2024, to identify randomized clinical trials on acupuncture treatment for MD. The Cochrane Risk of Bias 2.0 tool was used to assess the risk of bias in included studies, and meta-analysis was conducted by RevMan 5.4 and Stata 16.0 software.

RESULTS

Six studies were included in this review. The treatment group received acupuncture or acupuncture combined with Western medicine, while the control group was treated with Western medicine. The treatment group was superior to the control group in terms of efficacy rate (RR: 1.20; 95% CI: 1.11-1.29;  < 0.0001). The treatment group reduced dizziness handicap inventory (DHI) (MD: 6.94; 95% CI: 1.58-12.30;  = 0.01), tinnitus handicap inventory (THI) (MD: 6.52; 95% CI: 0.77-12.27;  = 0.03), stuffy ear visual analog scale (VAS) (MD: 0.87; 95% CI: 0.54-1.20;  < 0.0001) and pure tone audiometry score (MD: 6.57; 95% CI: 5.62-7.51;  < 0.0001) to a greater degree than those of the control group. There were some methodological shortcomings in the included studies, including failure to implement blinding, inappropriate outcome measures, and heterogeneity of clinical interventions, such as selected acupoints, acupuncture sessions, and therapist techniques.

CONCLUSION

Acupuncture may improve the symptoms of vertigo, tinnitus, ear fullness and hearing loss in patients with MD. However, due to the lack of literature included in this study and methodological weaknesses like randomization, blinding, and clinical heterogeneity, more well-designed long-term follow-up RCTs are needed to evaluate the efficacy and safety of acupuncture.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/(CRD42024549261).

摘要

背景

梅尼埃病(MD)是一种特发性慢性内耳疾病,严重影响患者的身心健康。药物治疗可能对部分患者有效,仍需要其他有效的治疗方法。本综述旨在评估针刺治疗MD的疗效。

方法

系统检索了8个数据库,检索时间从建库至2024年6月1日,以确定针刺治疗MD的随机临床试验。采用Cochrane偏倚风险2.0工具评估纳入研究的偏倚风险,并使用RevMan 5.4和Stata 16.0软件进行荟萃分析。

结果

本综述纳入了6项研究。治疗组接受针刺或针刺联合西药治疗,对照组接受西药治疗。治疗组在有效率方面优于对照组(RR:1.20;95%CI:1.11-1.29;P<0.0001)。治疗组在降低眩晕残障量表(DHI)(MD:6.94;95%CI:1.58-12.30;P=0.01)、耳鸣残障量表(THI)(MD:6.52;95%CI:0.77-12.27;P=0.03)、耳闷视觉模拟量表(VAS)(MD:0.87;95%CI:0.54-1.20;P<0.0001)和纯音听力计评分(MD:6.57;95%CI:5.62-7.51;P<0.0001)方面比对照组有更大程度的改善。纳入的研究存在一些方法学上的缺陷,包括未实施盲法、结局指标不合适以及临床干预的异质性,如所选穴位、针刺疗程和治疗师技术。

结论

针刺可能改善MD患者的眩晕、耳鸣、耳闷和听力损失症状。然而,由于本研究纳入的文献不足以及随机化、盲法和临床异质性等方法学上的弱点,需要更多设计良好的长期随访随机对照试验来评估针刺的疗效和安全性。

系统评价注册

https://www.crd.york.ac.uk/PROSPERO/(CRD42024549261)

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