针刺及联合其它疗法治疗反流性食管炎的系统评价
Systematic Evaluation of Acupuncture and Combined Therapies for Treating Reflux Esophagitis
-
摘要: 目的 系统评价针刺对反流性食管炎(RE)的疗效。方法 检索建库至2019年5月CNKI、WANFANG、VIP、CBM、PubMed、Embase、Cochrane Library数据库中针刺治疗RE的临床随机对照研究,提取纳入文献的基本资料并评价其质量,用Rev Man5.3软件进行Meta分析。结果 共纳入13个研究,共1 120名患者。在降低复发率方面,单独针刺或针药结合均优于西药[针刺:RR=0.21,95%CI(0.05,0.87);针刺+六君疏肝方:RR=0.44,95%CI(0.27,0.71) ;针刺+半夏泻心汤加减:RR=0.29,95%CI(0.14,0.60);针刺+旋覆代赭汤合左金丸加减:RR=0.40,95%CI(0.26,0.62);针刺+自拟中药方+微波热疗:RR=0.24,95%CI(0.08,0.66)]。在内镜有效率方面,电针联合西药治疗RE优于单独西药治疗[RR=1.23,95%CI(1.06,1.41)]。在降低症状积分方面,针药结合治疗RE的疗效较西药治疗更优[针刺+中药:RR=-1.73,95%CI(-3.21,-0.25),针刺+中药+西药:RR=-4.93,95%CI(-5.52,-4.34)]。针药结合治疗RE的不良反应少于单独西药治疗。结论 针药结合治疗RE安全有效且复发率低,然而单纯针刺治疗RE的疗效目前尚不明确,针灸治疗RE的相关研究亟需统一疗效标准,提高研究质量,未来仍需要更多高质量随机对照试验来验证针灸治疗RE的效果。Abstract: OBJECTIVE To systematically evaluate the efficacy of acupuncture in reflux esophagitis (RE). METHODS Based on retrieving the clinical randomized controlled studies on acupuncture treatment of RE in CNKI, WANFANG, VIP, CBM, PubMed, Embase and Cochrane Library databases up to May 2019, the related literature was extracted and evaluated with Meta-analysis on Rev Man5.3. RESULTS A total of 13 studies with 1 120 patients were included. In terms of reducing the recurrence rate, acupuncture alone or combination of acupuncture and medicine was superior to Western medicine [acupuncture alone: RR=0.21, 95%CI(0.05, 0.87); acupuncture + Liujun Shugan Decoction: RR=0.44, 95%CI(0.27, 0.71); acupuncture + Banxia Xiexin Decoction: RR=0.29, 95%CI(0.14, 0.60); acupuncture + Xuanfu Daizhe Decoction and Zuojin Pill: RR=0.40, 95%CI(0.26, 0.62); acupuncture + self-prescribed Chinese medicine + microwave hyperthermia: RR=0.24, 95%CI(0.08, 0.66)]. In terms of endoscopic efficiency, electroacupuncture combined with Western medicine was better than Western medicine alone[RR=1.23, 95%CI(1.06, 1.41)]. In terms of reducing the symptom scores, the combination of acupuncture and medicine was more effective than Western medicine [acupuncture + Chinese medicine: RR=-1.73, 95%CI(-3.21, -0.25), acupuncture + Chinese medicine + Western medicine: RR=-4.93, 95%CI(-5.52, -4.34)]. The adverse reactions of acupuncture combined with medicine were less than those of Western medicine alone.CONCLUSION In the treatment of RE, acupuncture combined with medicinal could obtain higher efficacy and lower recurrence while the efficacy of acupuncture alone is still unclear. Thus, there is an urgent need to standardize the efficacy of acupuncture in the treatment of RE and improve the quality of research. More high-quality randomized controlled trials are still needed in the future to validate the effectiveness of acupuncture for RE.
-
Key words:
- acupuncture /
- reflux esophagitis /
- systematic evaluation
-
[1] YAMASAKI T, HEMOND C, EISA M, et al. The changing epidemiology of gastroesophageal reflux disease: Are patients getting younger?[J]. J Neurogastroenterol Motil,2018,24(4):559. [2] 樊敏,曾斌芳.反流性食管炎的中医研究进展[J].新疆中医药,2018,36(3):85-88. [3] 徐谷清.奥美拉唑联合伊托必利治疗反流性食管炎的疗效分析[J].当代医学,2013,19(10):69-70. [4] 张友发,梁光造,张征.电针刺双足三里穴联合泮托拉唑治疗反流性食管炎的临床研究[J].中国医学创新,2013,10(7):93-94. [5] 周国赢.电针加耳针治疗反流性食管炎84例[J].中国中医药信息杂志,2004,11(10):907-909. [6] 刘玉生,张曙光.健脾理气和胃法针刺治疗反流性食管炎30例[J].中医临床研究,2016,8(1):85-86. [7] 刘炳辉,杨忠义,高晔,等.六君疏肝方加针刺治疗老年反流性食管炎41例疗效观察[J].河北中医,2012,34(8):1151-1152. [8] 周建松,高晔,杨忠义,等.六君疏肝方配合针刺治疗食管癌切除术后反流性食管炎疗效研究[J].河北中医药学报,2013,28(4):8-9. [9] 李枝锦,李静,吴平财.旋覆代赭汤与针刺联合西药治疗反流性食管炎随机平行对照研究[J].实用中医内科杂志,2016,30(9):52-55. [10] 刘顺益,丁喜艳,韩丽梅,等.针刺加云南白药糊剂治疗反流性食管炎20例[J].中国中医急症,2011,20(4):651-652. [11] 文娜,郝晋东,晋志高.针刺治疗肝胃郁热型反流性食管炎疗效观察[J].中国针灸,2010,30(4):285-288. [12] 曹雨佳.针灸治疗反流性食管炎90例疗效观察[J].亚太传统医药,2016,12(20):93-94. [13] 朱志强,郑颖颖,李贵,等.针药结合治疗肝胃郁热型反流性食管炎46例临床观察[J].中医杂志,2017,58(1):46-49. [14] 张友平.反流性食管炎中医综合治疗临床分析[J].中外健康文摘,2012,9(50):9. [15] 郭严.针刺配合西药治疗反流性食管炎31例[J].中原医刊,2007,34(11):59-60. [16] 李良玉,周兰利.中医综合疗法治疗反流性食管炎疗效观察[J].光明中医,2017,32(12):1693-1695. [17] SONG EM, JUNG HK, JUNG JM. The association between reflux esophagitis and psychosocial stress[J]. Digest Dis Sci,2013,58(2):471-477. [18] YANG XJ, JIANG HM, HOU XH, et al. Anxiety and depression in patients with gastroesophageal reflux disease and their effect on quality of life[J]. World J Gastroenterol,2015,21(14):4302. [19] 陈荣国,何敏,李志坚,等.返流性食管炎与精神因素的关系分析[J].中国实用医药,2017,12(17):27-29. [20] 胡水清,张玫.反流性食管炎和焦虑抑郁的相关性研究[J].新医学,2018,49(12):911-914.
点击查看大图
计量
- 文章访问数: 499
- HTML全文浏览量: 3
- PDF下载量: 362
- 被引次数: 0