针刺研究

2014, v.39(03) 238-246

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针刺治疗多囊卵巢综合征:随机对照试验的系统综述和Meta分析
A Meta-analysis on Acupuncture Treatment of Polycystic Ovary Syndrome

任丽娜;郭丽红;马文珠;张瑞;
REN Li-na;GUO Li-hong;MA Wen-zhu;ZHANG Rui;School of Acu-moxibustion and Tuina,Beijing University of Chinese Medicine;

摘要(Abstract):

目的:运用循证医学系统综述方法评价针刺治疗多囊卵巢综合征(PCOS)的疗效和安全性。方法:计算机检索CNKI、VIP、CBM、Wanfang、PubMed和Cochrane Library数据库,并对论文后的参考文献做补充检索。时间从建库(刊)到2013年11月。收集单纯针刺(或+药物/其它针灸疗法)对比阳性药物(或安慰剂/空白对照)治疗PCOS的随机对照试验(RCT)。对临床异质性较小的文献采用RevMan 5.2进行Meta分析,否则进行定性分析。结果:共纳入31项研究,合计2 321例PCOS患者。2个Meta分析结果显示:①单纯针刺组的有效率与西药组相当;②针刺结合中药组的有效率明显高于西药组。定性描述结果:单纯针刺(或+药物)治疗PCOS,在提高有效率、排卵率,降低黄体生成素/卵泡刺激素值、胰岛素抵抗水平、睾酮、体质量指数方面,优于或等效于对照组疗效。局限性:由于语种条件限制,存在文献检索选择偏倚;阳性结果易于发表使纳入研究存在潜在发表偏倚;无随访及报告结局时点不一致而存在时间效应偏倚;未对针刺的具体操作进行分类,致使本次研究有潜在的信息偏倚。结论:现有的研究证据对针刺治疗PCOS疗效还不能得出肯定的结论,针刺可能可以促进PCOS患者排卵。
Objective To evaluate the effect and safety of acupuncture treatment of polycystic ovary syndrome(PCOS)by using systematic review in view of evidence-based medicine(EBM).Methods Original articles about acupuncture treatment of PCOS published from the database-established year to November of 2013were searched from the Chinese National Knowledge Infrastructure Database(CNKI),Chongqing VIP Chinese Science and Technology Periodical Database(VIP),Chinese Biomedical Library(CBM),Wanfang Data,PubMed,and the Cochrane Library and the associated references-indicated papers by using keywords of polycystic ovary syndrome,randomization,acupoint,acupuncture,acupuncture plus moxibustion,acupuncture plus acupoint-embedment of catgut,and acupuncture plus otopoint application.Those articles about treatment of PCOS with simple abdominal acupuncture,simple acupoint-embedment of catgut,simple otopoint-pellet-pressure,and simple moxibustion treatment,and simple abstracts were excluded.If the articles re-published in both Chinese and English and in academic conferences and journals,one of them with higher quality was included.Two independent reviewers extracted data from located articles in a pre-defined structured way,and the Meta-analysis was conducted using software RevMan 5.2,otherwise using the qualitative analysis.Results A total of 31articles(28in Chinese,3in English)containing 2 321cases of PCOS patients met the included criteria.Meta-analysis showed that the clinical efficacy of simple acupuncture was the same as that of western medicine,and the efficacy of acupuncture combined with Chinese herbal medicine interventions was obviously higher than that of western medicine(P<0.05).In addition,simple acupuncture intervention and acupuncture combined with Chinese herbal medicines or with moxibustion treatment have advantages in reducing serum luteinizing hormone/follicle-stimulating hormone(LH/FSH),insulin resistance(IR),testosterone(T),and body mass index(BMI).However,the quality of the collected articles is generally lower due to unclear bias,no sample quantity estimation,incorrect randomization methods,no follow-up survey,etc.Conclusion Acupuncture therapy may be effective for PCOS,but needs to be confirmed further by larger sample randomized controlled trials.

关键词(KeyWords): 多囊卵巢综合征;针刺干预;随机对照试验;系统综述;Meta分析
Polycystic ovary syndrome;Acupuncture intervention;Randomized controlled trials;System review;Meta-analysis

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 任丽娜;郭丽红;马文珠;张瑞;
REN Li-na;GUO Li-hong;MA Wen-zhu;ZHANG Rui;School of Acu-moxibustion and Tuina,Beijing University of Chinese Medicine;

DOI: 10.13702/j.1000-0607.2014.03.017

参考文献(References):

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