针刺治疗绝经后骨质疏松症有效性及安全性的系统评价和Meta分析
Systemic review and meta-analysis of acupuncture in the treatment of postmenopausal osteoporosis
  
DOI:10.3969/j.issn.1006-7108.2019.04.006
中文关键词:  针刺  绝经后骨质疏松症  随机对照试验  系统评价  Meta分析
英文关键词:acupuncture  postmenopausal osteoporosis  randomized controlled trials  systematic review  meta-analysis
基金项目:北京中医药科技发展资金项目(JJ2016-79);中华中医药学会(2017-2019年度)青年人才托举工程项目(CACM-2017-QNRC2-A03)
作者单位
王凯莉1, 2 章轶立1 谢雁鸣1 魏戌3 姜俊杰1* 安一方4 1. 中国中医科学院中医临床基础医学研究所北京 100700 2. 中国中医科学院西苑医院北京 100091 3. 中国中医科学院望京医院科研处 北京 100102 4. 中国中医科学院广安门医院北京 100053 
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中文摘要:
      目的 评价针刺治疗绝经后骨质疏松症的有效性及安全性。方法 电子检索中文和英文数据库共6个,检索日期截至2017年11月,根据Cochrane Hand book 5.3评价标准和工具评价纳入研究的质量,并用Revman 5.3软件进行Meta分析。结果 共纳入10篇文献,包括710例患者,试验组354例,对照组356例。Meta分析显示:①针刺vs常规治疗[RR=1.36,95 % CI (1.18,1.57),Z=4.34,P<0.0001]、针刺+常规治疗vs常规治疗[RR=1.31,95% CI(1.14,1.50),Z=3.77,P=0.0002],在提高临床有效率上均优于对照组;②针刺vs常规治疗[MD=–2.36,95% CI (–4.20,–0.53),Z=2.53,P=0.01]、针刺+常规治疗vs常规治疗[MD=–1.61,95% CI (–2.06,–1.16),Z=7.01,P<0.00001],在改善疼痛评分上均优于对照组。结论 与单用常规治疗相比,针刺或针刺联合常规治疗在提高临床治疗有效率、改善疼痛方面疗效更优,适于临床采纳应用。但考虑到纳入文献的局限性,在今后的研究中需要更多高质量、大样本、多中心、方法学设计严谨的随机对照试验,进一步佐证并提升针刺治疗绝经后骨质疏松症有效性和安全性证据强度。
英文摘要:
      Objectice To evaluate the efficacy and safety of acupuncture in the treatment of postmenopausal osteoporosis (PMOP). Methods Six Chinese and English databases were searched electronically, and the retrieval date was up to November 2017. According to the Cochrane Hand book 5.3, the quality of the research included in this study was assessed. Meta-analyses were performed using Revman 5.3 Software. Results A total of 10 articles were included, including 710 patients, with 354 cases in the trial group and 356 cases in the control group. Meta-analyses showed that: ①Acupuncture compared with conventional therapy (CT) [RR=1.36, 95% CI (1.18, 1.57), Z=4.34, P<0.0001], Acupuncture + CT compared with CT [RR=1.31, 95% CI (1.14, 1.50), Z=3.77, P=0.0002], indicating that Acupuncture and Acupuncture + CT both could improve clinic efficiency; ②Acupuncture compared with CT [MD=-2.36, 95% CI (–4.20, –0.53), Z=2.53, P=0.01], Acupuncture + CT compared with CT [MD=–1.61, 95% CI (–2.06, –1.16), Z=7.01, P<0.00001], indicating that both Acupuncture and Acupuncture + CT all could reduce pain degree. Conclusion Compared with conventional treatment alone, acupuncture or acupuncture combined with conventional therapy can improve the effective rate and pain symptoms. It is worthy of clinical application. However, in view of the limitations of the included literature, there is a need for more high-quality, large sample, multicenter, well-designed randomized controlled trials in future research, to further support and enhance the effectiveness and safety of acupuncture for postmenopausal osteoporosis.
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