针刺疗程次数与颈性眩晕疗效的量效关系：基于随机对照试验的Meta回归分析
[Dose-effect relationship between the number of acupuncture sessions and efficacy for cervical vertigo: a Meta-regression analysis based on randomized controlled trials].
作者信息
Zhang Yixuan, Yang Rui, Zhang Chunchang, Han Lin
机构信息
First Teaching Hospital of Tianjin University of TCM, Tianjin 300381, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381; Graduate School of Tianjin University of TCM, Tianjin 301617.
First Teaching Hospital of Tianjin University of TCM, Tianjin 300381, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381.
出版信息
Zhongguo Zhen Jiu. 2025 Aug 12;45(8):1180-1186. doi: 10.13703/j.0255-2930.20240711-0002. Epub 2024 Nov 28.
OBJECTIVE
To explore the dose-effect relationship between the number of acupuncture sessions and the efficacy for cervical vertigo (CV).
METHODS
Literature regarding randomized controlled trials (RCTs) of acupuncture for CV was retrieved from CNKI, Wanfang, VIP, Web of Science, and PubMed databases from inception to June 28th, 2024. Studies were included if patients were treated solely with acupuncture and the core prescription included Baihui (GV20)-Fengchi (GB20)-neck-jiaji (EX-B2). Outcomes included the evaluation scale for cervical vertigo symptoms and function (ESCV) score and the mean blood flow velocity of vertebrobasilar arteries. The Cochrane risk of bias assessment tool 2.0 was used to evaluate study quality. Dose-effect Meta-regression analysis was performed using the robust-error Meta-regression (REMR) method in Stata 17.0 software.
RESULTS
Nineteen RCTs were included with a total of 747 patients in the experimental groups. After 10 sessions of acupuncture, the ESCV score increased to 20.29 (95% : 16.77, 23.80), with a pre-post ESCV difference of 4.60 (95% : 2.59, 6.60) and an improvement rate of 0.36 (95% : 0.26, 0.46). After 20 sessions of acupuncture, the ESCV score increased to 21.55 (95% : 18.87, 24.22), with a difference of 5.42 (95% : 3.87, 6.97) and an improvement rate of 0.39 (95% : 0.31, 0.48). After 10 sessions of acupuncture, the improvement rates for left vertebral artery (LVA), right vertebral artery (RVA), and basilar artery (BA) mean blood flow velocities were 0.08 (95% : 0.05, 0.12), 0.09 (95% : 0.05, 0.12), and 0.11 (95% : 0.06, 0.15), respectively. After 14 sessions of acupuncture, the improvement rates reached their peaks: LVA [0.09 (95% : 0.06, 0.12)], RVA [0.10 (95% : 0.07, 0.13)], and BA [0.12 (95% : 0.07, 0.16)].
CONCLUSION
A nonlinear dose-effect relationship existed between the number of acupuncture sessions and the efficacy for CV. Fourteen sessions were recommended as the optimal number of acupuncture treatments.
目的
探讨针刺疗程数与颈性眩晕（CV）疗效之间的剂量-效应关系。
方法
从中国知网、万方、维普、Web of Science和PubMed数据库中检索自建库至2024年6月28日关于针刺治疗CV的随机对照试验（RCT）文献。纳入仅采用针刺治疗且核心处方包括百会（GV20）-风池（GB20）-颈夹脊（EX-B2）的研究。结局指标包括颈性眩晕症状与功能评估量表（ESCV）评分及椎基底动脉平均血流速度。采用Cochrane偏倚风险评估工具2.0评估研究质量。使用Stata 17.0软件中的稳健误差Meta回归（REMR）方法进行剂量-效应Meta回归分析。
结果
纳入19项RCT，实验组共747例患者。针刺10个疗程后，ESCV评分升至20.29（95%：16.77，23.80），ESCV前后差值为4.60（95%：2.59，6.60），改善率为0.36（95%：0.26，0.46）。针刺20个疗程后，ESCV评分升至21.55（95%：18.87，24.22），差值为5.42（95%：3.87，6.97），改善率为0.39（95%：0.31，0.48）。针刺10个疗程后，左椎动脉（LVA）、右椎动脉（RVA）和基底动脉（BA）平均血流速度的改善率分别为0.08（95%：0.05，0.12）、0.09（95%：0.05，0.12）和0.11（95%：0.06，0.15）。针刺14个疗程后，改善率达到峰值：LVA[0.09（95%：0.06，0.12）]、RVA[0.10（95%：0.07，0.13）]和BA[0.12（95%：0.07，0.16）]。
结论
针刺疗程数与CV疗效之间存在非线性剂量-效应关系。推荐14个疗程作为针刺治疗的最佳疗程数。
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