针灸治疗变应性鼻炎临床随机对照试验系统评价

目的:评价针灸治疗变应性鼻炎的临床疗效及安全性,分析目前临床研究的现状.方法:检索PubMed、Cochrane图书馆、CBM数据库、CNKI数据库等收集针灸治疗变应性鼻炎临床随机对照试验,选择符合纳入标准的临床试验,以Cochrane系统评价手册5.0进行质量评价,统计学分析采用RevMan 4.2.8.结果:12篇文献符合纳入标准,共1 076例患者.Meta分析显示针灸治疗变应性鼻炎与常规药物治疗治愈率比较,差异有统计学意义[合并RR(固定效应模型)=1.86,95%CI(1.51,2.29),Z=5.82,P＜0.000 01];针灸治疗与常规药物显效率比较,差异有统计学意义[合并RR(固定效应模型)=1.58,95%CI(1.32,1.89),Z=4.94,P＜0.000 01].结论:针灸治疗变应性鼻炎安全、有效,对照常规药物可能有一定优势.但因纳入部分文献质量较低,结论尚不确定,尚需高质量研究进一步验证针灸治疗变应性鼻炎的优势性.

Systematic evaluation of the randomized controlled trials about acupuncture and moxibustion treatment of allergic rhinitis

Objective To evaluate the clinical effect and safety of acupuncture and moxibustion treatment for allergic rhinitis and to analyze the present situation of clinical researches. Methods A search in PubMed, Cochrane Library, Chinese Biology Medicine (CBM) disk, and China National Knowledge Infrastructure (CNKI) databases was performed to gather the randomized controlled trials about acupuncture and moxibustion treatment for allergic rhinitis, identify additional clinical trials met the inclusion criteria and measure their qualities by using Cochrane Reviewers' Handbook 5. 0. Statistical analysis was carried out by RevMan 4. 2. 8. Results A meta-analysis was performed on a total of 1 076 patients involved in 12 papers which met the inclusion criteria. There were significant differences in both cure rate (Incorporate RR=1. 86, 95%CI 1. 51, 2. 29, Z=5. 82, P＜0.000 01) and marked improvement rate (Incorporate RR=1.58, 95%CI 1.32, 1.89, Z=4.94, P＜0. 00001) between acupuncture and moxibustion treatment and the routine medicine treatment for allergic rhinitis. Conclusion Acupuncture and moxibustion to treat allergic rhinitis is effective and safe and may have certain advantage over the routine medicine treatment. However, as for the low quality of partial inclusion literatures, no definite conclusion can be obtained as yet and it still waits for higher quality researches to further prove the dominance of acupuncture and moxibustion treatment for allergic rhinitis.