针刺联合高压氧治疗与单纯高压氧治疗对创伤性脑损伤患者的疗效比较：一项系统评价和荟萃分析

The effect of acupuncture combined with hyperbaric oxygenation compared with hyperbaric oxygenation alone for patients with traumatic brain injury: a systematic review and meta-analysis.

作者信息

Li Geng, Wang Binyang, Fan Shuochen, Liu Shuangli, Shao Lu, Li Chuanxiong, Fang Yongjiang, Li Jianfeng, Qiu Meihua, Zhang Yuping, Pan Lei

机构信息

The Second Clinical Medical College, Yunnan University of Traditional Chinese Medicine, Kunming, China.

Kunming Medical University, Kunming Medical University, Kunming, China.

出版信息

Front Neurol. 2025 May 2;16:1538740. doi: 10.3389/fneur.2025.1538740. eCollection 2025.

DOI:10.3389/fneur.2025.1538740

PMID:40386021

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12083083/

Abstract

OBJECTIVE

This study aimed to evaluate the effects of acupuncture combined with hyperbaric oxygenation (HBO) compared with HBO alone in improving the disturbance of consciousness (DOC) of people with traumatic brain injury (TBI).

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in this study. In accordance with the preestablished search strategy, all the literature was obtained from eight online databases. Following the stringent application of inclusion and exclusion criteria, two researchers conducted an independent extraction of valid data from eligible randomized controlled trials (RCTs). The risk of bias in each study was assessed using the Cochrane Risk of Bias 2.0 tool. The meta-analysis was conducted utilizing the RevMan software. Adverse events were determined based on data from each study assessing the safety of acupuncture treatment.

RESULTS

A total of 11 RCTs with 896 participants were included in the analysis. Overall, the methodological quality of the RCTs encompassed within this meta-analysis was below standard. The pooled data demonstrated that acupuncture treatment combined with HBO was significantly superior to HBO alone, based on the Glasgow Coma Scale (GCS) scores [mean difference (MD) = 2.13, 95% confidence interval (CI): 1.64-2.62,  < 0.00001]. We also found that electroacupuncture (EA) combined with HBO improved GCS scores more than HBO alone in TBI patients (MD = 2.15, 95% CI: 1.95-2.36). The early intervention (MD = 3.09, 95% CI, 2.66-3.52) demonstrated significantly more significant improvement in GCS scores following combination therapy compared with the late intervention group (MD = 1.86, 95% CI, 1.47-2.25). Furthermore, compared with HBO alone, acupuncture combined with HBO significantly improved patients' consciousness rate (CR) (RR = 2.26, 95% CI: 1.48-3.46). Statistical analysis also revealed that acupuncture combined with HBO improved the effective rate (ER) (RR = 1.47, 95% CI: 1.27-2.69). Additionally, no studies reported any significant adverse events.

CONCLUSION

Compared with HBO alone, acupuncture combined with HBO has a more substantial positive effect on GCS scores, AR, and ER in patients with TBI. However, given the limited availability of high-quality evidence and the dearth of RCTs in this area, the conclusions drawn herein warrant validation through additional research endeavours.

CLINICAL TRIAL REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024576067, CRD42024576067.

摘要

目的

本研究旨在评估针刺联合高压氧（HBO）与单纯HBO相比，对改善创伤性脑损伤（TBI）患者意识障碍（DOC）的效果。

方法

本研究遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。按照预先制定的检索策略，从八个在线数据库中获取所有文献。在严格应用纳入和排除标准后，两名研究人员对符合条件的随机对照试验（RCT）进行了有效数据的独立提取。使用Cochrane偏倚风险2.0工具评估每项研究的偏倚风险。利用RevMan软件进行Meta分析。根据评估针刺治疗安全性的每项研究数据确定不良事件。

结果

共纳入11项RCT，896名参与者。总体而言，该Meta分析中纳入的RCT的方法学质量低于标准。汇总数据表明，基于格拉斯哥昏迷量表（GCS）评分，针刺联合HBO治疗显著优于单纯HBO治疗[平均差（MD）=2.13，95%置信区间（CI）：1.64 - 2.62，P<0.00001]。我们还发现，电针（EA）联合HBO在TBI患者中比单纯HBO更能提高GCS评分（MD = 2.15，95% CI：1.95 - 2.36）。与晚期干预组相比，早期干预（MD = 3.09，95% CI，2.66 - 3.52）在联合治疗后GCS评分改善更显著（MD = 1.86，95% CI，1.47 - 2.25）。此外，与单纯HBO相比，针刺联合HBO显著提高了患者的意识恢复率（CR）（RR = 2.26，95% CI：1.48 - 3.46）。统计分析还显示，针刺联合HBO提高有效率（ER）（RR = 1.47，95% CI：1.27 - 2.69）。此外，没有研究报告任何显著的不良事件。