针刺治疗经前期紧张综合征的META分析及临床观察

发布时间：2018-03-25 17:09

本文选题：针刺　切入点：经前期紧张综合征　出处：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:通过META分析,对针刺治疗经前期紧张综合征的临床疗效进行评价,为后续针刺治疗经前期紧张综合征临床研究提供一定的理论基础及临床治疗经验。方法:以循证学为依据,检索近16年国内外针刺治疗经前期紧张综合征的RCT试验,并对纳入文献进行质量评价,meta分析使用Revman5.1软件进行,以异质性检验结果为依据来进行效应模型的选择,选择相对危险度(risk ratio,RR)来表示结局效应指标,均以95%可信区间(conf idence interval,CI)表示。结果:本研究共纳入12个研究,共计865名患者,其中对照组为西药的文章9篇,对照组为中药的文章2篇,对照组既有中药也有西药的文章1篇(此文章分2次统计)。Meta分析结果显示:1、对照组为西药的10个研究(其中1个研究采用针刺VS中药VS西药分别对照)均采用有效率作为结局指标,Meta分析结果显示,合并OR:4.23[2.78,6.44],总体效应P0.00001(P0.05),针刺组与西药对照组临床总有效率差异有统计学意义,针刺疗效优于西药。其中4个研究对头痛指数进行分析,Meta分析结果显示,头痛指数MD:-4.57[-7.14,-1.72],总体效应P=0.0002(P0.05),针刺组疗效优于西药组。其中2个研究对复发率进行分析,Meta分析结果显示,合并OR:0.36[0.15,0.86],总体效应P=0.02(P0.05),说明针刺复发率小于西药。2、对照组为中药的3个研究(其中1个研究采用针刺VS中药VS西药分别对照)均采用有效率作为结局指标,Meta分析结果显示,合并OR:1.83[0.81,4.12],总体效应P=0.14(P0.05),针刺组与中药组疗效相当。结论:针刺作为经前期紧张综合征的一种治疗方法,临床可以学习及借鉴,本研究为后续针刺治疗经前期紧张综合征临床研究提供一定的理论基础及临床治疗经验。但文献的整体质量普遍偏低,这使得研究结果的可信度在一定程度上受到影响,故有待于今后大样本、高质量的RCT进行验证。
[Abstract]:Objective: to evaluate the clinical effect of acupuncture on premenstrual tension syndrome by META analysis. To provide certain theoretical basis and clinical treatment experience for the follow-up clinical study of acupuncture in treating premenstrual tension syndrome. Methods: based on the evidence-based study, the RCT test of acupuncture therapy for premenstrual tension syndrome in recent 16 years at home and abroad was searched. According to the results of heterogeneity test, the effect model was selected, and the relative risk risk index was chosen to express the outcome effect index. Results: a total of 865 patients were included in this study, including 9 articles on western medicine in control group and 2 articles on traditional Chinese medicine in control group. In the control group, there was one article on both traditional Chinese medicine and western medicine (this article was divided into 2 statistical analyses. Meta-analysis showed that the control group was 10 studies of western medicine (one of which was treated with acupuncture vs Chinese medicine vs western medicine respectively). Efficiency as a result of meta-analysis showed that, Combined with OR:4.23 [2.78 卤6.44], the overall effect was P0.00001 and P0.050.The total effective rate of acupuncture group was significantly different from that of western medicine control group, and the acupuncture effect was superior to western medicine, among which four studies analyzed the headache index and the results of Meta-analysis showed that the total effective rate of acupuncture group was higher than that of western medicine group, and the total effective rate of acupuncture group was better than that of western medicine group. Headache index (MD:-4.57) [-7.14 ~ 1.72], the overall effect was 0.0002 ~ 0.05%, the curative effect of acupuncture group was better than that of western medicine group, and the recurrence rate was analyzed by two studies and the results of Meta-analysis showed that the total effect of acupuncture group was better than that of western medicine group. Combined with OR:0.36 [0.150.86], the overall effect was 0.02% P0.05A, indicating that the recurrence rate of acupuncture was lower than that of western medicine .2.The control group was three studies of traditional Chinese medicine (one of which was treated with acupuncture vs western medicine respectively) and the effective rate was used as the result index of meta-analysis. Combined with OR:1.83 [0.81 卤4.12], the overall effect was 0.14 and P0.05.The curative effect of acupuncture group was similar to that of traditional Chinese medicine group. Conclusion: as a treatment method of premenstrual stress syndrome, acupuncture can be studied and used for reference in clinic. This study provides a certain theoretical basis and clinical treatment experience for the follow-up clinical study of acupuncture in the treatment of premenstrual tension syndrome. However, the overall quality of the literature is generally low, which makes the reliability of the results affected to some extent. So it needs to be verified by large sample and high quality RCT in the future.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.3

【参考文献】