杵针疗法临床应用32项随机对照试验的系统评价
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摘要
目的:系统评价杵针临床应用的有效性及安全性,为其临床推广提供证据支持。方法:计算机检索PubMed、EMBase、Cochrane Library、Web of Science以及CBM、CNKI、VIP和WanFang共8个数据库,收集所有杵针临床应用的随机对照试验(RCT),实施定性或定量分析。结果:共纳入32篇RCT(2618例患者)。定性分析显示杵针在以下疾病类型的临床治疗中疗效肯定,如颈椎病、失眠症、腰腿痛、亚健康状态、心脑血管疾病、中风后抑郁症、偏头痛、面部美容问题、神经源性膀胱及髋关节置换术后患者的康复。通过定量分析发现,在亚健康状态的治疗中,杵针组总有效率显著高于推拿组,其Meta分析的合并效应量为[OR=3. 18,95%CI=(1. 37,7. 40),P=0. 007];在颈椎病、腰腿痛、脑动脉粥样硬化症、失眠症和偏头痛的治疗中,杵针组和针刺组总有效率差异无统计学意义。结论:杵针在颈椎病、失眠症、腰腿痛及亚健康状态等10余种疾病治疗中疗效肯定,具备良好的临床有效性和安全性,应在临床中大力推广。
Objective: To systematically review the efficacy and safety of pestle needle therapy for clinical treatment,and to provide the evidence for its clinical expansion. Methods: A computer-based retrieval was performed in eight databases including PubMed,EMbase,Cochrane Library,Web of Science,CBM,CNKI,VIP and Wan Fang. All relevant randomized controlled trials( RCTs) were collected to systematically research pestle needle therapy for clinical treatment.Finally,qualitative or quantitative analyses were performed. Results: A total of 32 literatures were included,comprising 2618 patients. Qualitative analysis showed that the pestle needle therapy was effective and secure in the clinical treatment of the following types of diseases: cervical spondylosis,insomnia,lumbocrural pain,sub-health,cardiac-cerebral vascular disease,post-stroke depression,migraine,facial beauty problems,neurogenic bladder and rehabilitation of patients after hip replacement. After quantificationally analyzed,we found that total efficiency of the pestle needle group was significantly higher than that of the massage group in the treatment of sub-health,and the synthetic effect of meta-analysis was [OR =3. 18,95%CI =( 1. 37,7. 40),P = 0. 007]; however,there was no statistically significant difference in total efficiency between pestle needle and acupuncture groups in the treatment of cervical spondylosis,lumbocrural pain,cerebral atherosclerosis,insomnia and migraine. Conclusions: The pestle needle has good clinical efficacy and safety in the treatment of more than ten diseases such as cervical spondylosis,insomnia,lumbocrural pain,sub-health,and so on.Pestle needle therapy is effective and secure,so it should be widely promoted in clinical practice.
Objective: To systematically review the efficacy and safety of pestle needle therapy for clinical treatment,and to provide the evidence for its clinical expansion. Methods: A computer-based retrieval was performed in eight databases including PubMed,EMbase,Cochrane Library,Web of Science,CBM,CNKI,VIP and Wan Fang. All relevant randomized controlled trials( RCTs) were collected to systematically research pestle needle therapy for clinical treatment.Finally,qualitative or quantitative analyses were performed. Results: A total of 32 literatures were included,comprising 2618 patients. Qualitative analysis showed that the pestle needle therapy was effective and secure in the clinical treatment of the following types of diseases: cervical spondylosis,insomnia,lumbocrural pain,sub-health,cardiac-cerebral vascular disease,post-stroke depression,migraine,facial beauty problems,neurogenic bladder and rehabilitation of patients after hip replacement. After quantificationally analyzed,we found that total efficiency of the pestle needle group was significantly higher than that of the massage group in the treatment of sub-health,and the synthetic effect of meta-analysis was [OR =3. 18,95%CI =( 1. 37,7. 40),P = 0. 007]; however,there was no statistically significant difference in total efficiency between pestle needle and acupuncture groups in the treatment of cervical spondylosis,lumbocrural pain,cerebral atherosclerosis,insomnia and migraine. Conclusions: The pestle needle has good clinical efficacy and safety in the treatment of more than ten diseases such as cervical spondylosis,insomnia,lumbocrural pain,sub-health,and so on.Pestle needle therapy is effective and secure,so it should be widely promoted in clinical practice.
引文
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[24]刘泽恩,余洋,郑驰前,等.中药熏洗结合杵针治疗腰腿痛(寒湿证)疗效观察[J].四川中医,2015,33(9):112-113.
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[26]刘栩豪,余洋,钟磊,等.应用TTM评价杵针治疗寒湿型腰腿痛的临床疗效研究[J].针灸临床杂志,2016,32(9):54-57.
[27]韩晶,徐贞杰,邢琳,等.杵针干预亚健康状态40例临床研究[J].江苏中医药,2011,43(12):63-65.
[28]徐贞杰,张金星,韩晶,等.杵针疗法干预亚健康状态临床观察[J].上海针灸杂志,2011,30(2):118-119.
[29]胡幼平,徐贞杰,吴佳,等.杵针疗法干预亚健康状态:随机对照研究[J].中国针灸,2012,32(11):1019-1023.
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[31]卢静,贾天贵,何刚,等.杵针疗法治疗脑动脉粥样硬化70例[J].针灸临床杂志,2005,21(12):29-31.
[32]刘全让,卓毅,卢静,等.杵针与针刺治疗对脑动脉粥样硬化症脑供血不足的作用与临床疗效附(282例病例报告)[J].成都中医药大学学报,2006,29(1):1-4.
[33]周群,蒋运兰,郭秋月,等.杵针疗法结合情志护理对中风后抑郁患者康复效果的影响[J].南京中医药大学学报,2014,30(6):534-537.
[34]蒲慧琴,陈涛,宋国红,等.杵针疗法结合阶段性护理对脑卒中后抑郁症患者神经功能及生活质量的影响[J].内科,2017,12(2):251-254.
[35]钟磊,董远蔚,杨斐,等.杵针治疗无先兆偏头痛临床研究[J].山东中医杂志,2016,35(7):605-606.
[36]谢雯.穴位杵针配合面部精油按摩瘦脸的临床疗效观察[J].成都:成都中医药大学,2010.
[37]刘素桃.杵针刺激面部阳明经穴配合面部按摩对女性面部皮肤含水量的临床疗效观察[J].成都:成都中医药大学,2013.
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[39]沈音丽,郭鸿,王洁莹,等.杵针疗法联合膀胱功能训练干预神经源性膀胱的临床研究[J].四川中医,2017,35(9):175-177.
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[2] HU Y,LI Z,MI DH,et al. Chemoradiation combined with regional hyperthermia for advanced oesophageal cancer:a systematic review and meta-analysis[J]. J Clin Pharm Ther,2017,42(2):155-164.
[3]李仲愚,钟枢才,李淑仁,整理.杵针治疗学[M].成都:四川科学技术出版社,1990:349.
[4]钟枢才.杵针学[M].北京:中国中医药出版社,2006:136.
[5] LI Z,MI DH,YANG KH,et al. Comparison between Autocad and Draftsight in data extraction[M]. Cochrane Database Syst Rev,2013,2013(9Suppl):P(56).
[6] LI Z,YANG KH,MI DH,et al. The method of exracting data from figure with software[M]. Cochrane Database Syst Rev,2012,2012(9Suppl):P(104).
[7]胡月,李征,曲雁,等.胸腔化疗联合热疗治疗癌性胸腔积液有效性和安全性的Meta分析[J].中国全科医学,2017,20(32):4034-4041.
[8]胡月,李征,曲雁,等.热疗综合疗法治疗原发性鼻咽癌的系统评价[J].循证医学,2015,15(2):96-101.
[9]蒋振亚,李常度.杵针大椎八阵穴为主治疗颈椎病的临床观察[J].中国针灸,2001,21(2):94-96.
[10]李少华.杵针“大椎八阵”穴治疗神经根型颈椎病的临床研究[M].成都:成都中医药大学,2009.
[11]苏敏.杵针疗法治疗椎动脉型颈椎病的临床疗效观察[C].中山:第二届全国民间中医药开发工程大会论文集. 2013:158-160.
[12]刘泽恩.杵针结合蜡疗治疗混合型颈椎病疗效观察[J].实用中医药杂志,2015,31(2):130.
[13]董远蔚,杨斐,钟磊.杵针配合牵引治疗颈性眩晕[J].吉林中医药,2016,36(4):417-418.
[14]杜越,杨斐,董远蔚,等.杵针治疗颈性眩晕临床疗效观察[J].医学信息,2016,29(12):286-287.
[15] WANG YZ,ZHONG L,WU ZJ,et al. Efficacy study on pestle needle combined with Chinese herbal fumigation for cervical spondylosis[J]. J Acupunct Tuina Sci,2016,14(4):284-289.
[16]税毅冬,尹玲,刘健佳,等.杵针对缓解神经根型颈椎病疼痛的效果观察[J].四川中医,2017,35(3):189-190.
[17]丰芬,阎博华,邓国忠.杵针百会八阵结合足疗治疗失眠症的临床研究[J].辽宁中医杂志,2009,36(4):617-618.
[18]胡幼平,李鸿,尹重,等.杵针治疗失眠疗效观察[J].中国针灸,2009,29(5):365-369.
[19]雷静涵.杵针配合耳穴贴压治疗失眠症疗效观察[J].上海针灸杂志,2013,32(7):548-550.
[20]梁清芳.杵针对老年失眠的临床操作规范化研究[J].成都:成都中医药大学,2013.
[21]吴际军,梁清芳,雷玉芳,等.杵针疗法对老年轻度抑郁患者睡眠质量的影响[J].中国疗养医学,2016,25(8):795-798.
[22]梁小利,梁清芳,王红艳,等.老年失眠症杵针疗法的效果.[J]中国老年学杂志,2017,37(4):1005-1006.
[23]刘栩豪,樊效鸿,钟磊,等.杵针为主治疗寒湿型腰腿痛疗效观察[J].上海针灸杂志,2015,34(9):876-879.
[24]刘泽恩,余洋,郑驰前,等.中药熏洗结合杵针治疗腰腿痛(寒湿证)疗效观察[J].四川中医,2015,33(9):112-113.
[25]陈日高,钟磊,董元蔚,等.杵针治疗气滞血瘀型腰腿痛的临床疗效观察[J].湖南中医药大学学报,2016,36(6):43-44.
[26]刘栩豪,余洋,钟磊,等.应用TTM评价杵针治疗寒湿型腰腿痛的临床疗效研究[J].针灸临床杂志,2016,32(9):54-57.
[27]韩晶,徐贞杰,邢琳,等.杵针干预亚健康状态40例临床研究[J].江苏中医药,2011,43(12):63-65.
[28]徐贞杰,张金星,韩晶,等.杵针疗法干预亚健康状态临床观察[J].上海针灸杂志,2011,30(2):118-119.
[29]胡幼平,徐贞杰,吴佳,等.杵针疗法干预亚健康状态:随机对照研究[J].中国针灸,2012,32(11):1019-1023.
[30]杜辛,刘全让,李淑仁,等.李仲愚杵针治疗心血管病83例临床观察[J].中西医结合杂志,1991,11(7):413-414.
[31]卢静,贾天贵,何刚,等.杵针疗法治疗脑动脉粥样硬化70例[J].针灸临床杂志,2005,21(12):29-31.
[32]刘全让,卓毅,卢静,等.杵针与针刺治疗对脑动脉粥样硬化症脑供血不足的作用与临床疗效附(282例病例报告)[J].成都中医药大学学报,2006,29(1):1-4.
[33]周群,蒋运兰,郭秋月,等.杵针疗法结合情志护理对中风后抑郁患者康复效果的影响[J].南京中医药大学学报,2014,30(6):534-537.
[34]蒲慧琴,陈涛,宋国红,等.杵针疗法结合阶段性护理对脑卒中后抑郁症患者神经功能及生活质量的影响[J].内科,2017,12(2):251-254.
[35]钟磊,董远蔚,杨斐,等.杵针治疗无先兆偏头痛临床研究[J].山东中医杂志,2016,35(7):605-606.
[36]谢雯.穴位杵针配合面部精油按摩瘦脸的临床疗效观察[J].成都:成都中医药大学,2010.
[37]刘素桃.杵针刺激面部阳明经穴配合面部按摩对女性面部皮肤含水量的临床疗效观察[J].成都:成都中医药大学,2013.
[38]李燕红.隔姜灸神阙穴结合眼周按摩治疗脾肾阳虚型黑眼圈的临床疗效观察[J].成都:成都中医药大学,2016.
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