穴位自血疗法治疗慢性荨麻疹的系统评价

发布时间：2018-03-05 15:36

本文选题：穴位注射　切入点：自血疗法　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过采用Cochrane系统评价方法对目前穴位自血疗法治疗慢性荨麻疹的有效性及安全性的现状进行评价,为穴位自血疗法治疗慢性荨麻疹临床实践与研究提供依据。方法:通过电子检索Pub Med、Cochrane Library、Embase中国知网、维普、万方、中国生物期刊文献数据库,检索时间从数据库建库至2015年12月,收集穴位自血疗法与空白、安慰剂或中药和或西药对照治疗慢性荨麻疹的随机和半随机对照临床试验,按照Cochrane Handbook 5.1.0标准对纳入的研究进行质量评价和数据提取,使用Rev Man 5.2软件进行Meta分析。对无法进行Meta分析的研究,单篇逐一分析。结果:本研究最终纳入8篇文献(8个随机对照试验),合计937位CU患者。纳入的研究中,其中5个明确说明使用随机数表产生随机数列,3个说明使用随机分组但未提及使用何种方法产生随机数列。所有研究均未提及分配隐藏。所有研究均报道了愈显率和总有效率,6篇文献报道了复发率,6篇文献提及了不良反应。穴位自血疗法vs口服氯雷他定共有3个研究比较了CU疗效的总有效率、愈显率、复发率,Meta分析结果显示,总有效率[RR=1.05,95%CI(0.97,1.13),P=0.21],两组无显著性差异;愈显率[RR=1.12,95%CI(0.98,1.28),P=0.21]两组无显著性差异;复发率[RR=0.10,95%CI(0.04,0.28),P0.00001]差异有统计学意义,穴位自血疗法的复发率仅为单纯口服氯雷他定的1/10。结论:纳入文献的方法学质量偏低,存在发表偏倚,影响结果的可信度。但低级证据并不表示临床价值,针对治疗CU的穴位自血疗法的临床应用还需结合实施者的临床技术水平和患者自身条件与意愿来考量。穴位自血疗法治疗慢性荨麻疹疗效与安全性还需要大样本、多中心、随机双盲临床对照试验来进一步证实。
[Abstract]:Objective: to evaluate the efficacy and safety of acupoint self-blood therapy in the treatment of chronic urticaria by using Cochrane system. Methods: electronic retrieval of Pub MedCochrane Library Embase, Weip, Wanfang, and Chinese biological journal literature database, from the establishment of the database to December 2015, was carried out in order to provide the basis for clinical practice and research on the treatment of chronic urticaria by self-blood therapy at acupoints. The randomized and semi-randomized controlled clinical trials of acupoint self-blood therapy and blank, placebo or traditional Chinese medicine or western medicine for chronic urticaria were collected, and the quality evaluation and data extraction were performed according to Cochrane Handbook 5.1.0 standard. Rev Man 5.2 software was used for Meta analysis. For the study which could not be analyzed by Meta, one by one. Results: this study was included in 8 articles (8 randomized controlled trials, 937 patients with CU). Of these, 5 explicitly stated the use of random number tables to generate random sequences, 3 used random grouping but did not mention the method used to generate random sequences. All studies did not mention allocation and concealment. The total effective rate and the total effective rate were reported in 6 articles, including 6 references to adverse reactions. There were three studies comparing the total effective rate of CU in acupoint self-blood therapy vs oral loratadine. The results of Meta-analysis showed that the total effective rate [RRN1.0595] had no significant difference between the two groups, but there was no significant difference between the two groups [RRN1.1295CII 0.981.28P0.21], and the recurrence rate [RRN0.1095CIT 0.040.040.28P0.00001] had a significant difference between the two groups. The recurrence rate of acupoint self-blood therapy was only 1 / 10 of that of oral loratadine alone. Conclusion: the quality of methodology included in the literature is on the low side, publication bias exists, which affects the credibility of the results, but the low level of evidence does not mean the clinical value. The clinical application of acupoint self-blood therapy for CU needs to be considered in combination with the clinical technical level of the implementers and the patients' own condition and willingness. The efficacy and safety of acupoint self-blood therapy for chronic urticaria also need a large sample and multi-center. Randomized double blind clinical controlled trials were further confirmed.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.7

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