弱氦氖激光血管内照射治疗缺血性脑卒中临床试验文献评价

目的:了解中国弱氦氖激光血管内照射(intravascularlowleverHe-Nelaserirradiationonblood,ILIB)治疗缺血性脑卒中(cerebralischemicstroke,CIS)随机对照试验和临床对照试验(RCTs/CCTs)的现状,为其系统评价提供线索。方法:通过机检和手检获得发表的RCTs/CCTs共64篇,对文献的随机化分配方法、盲法采用、样本含量、患者纳入标准和排除标准、疗效判定标准、不良反应报告、治疗依从性、随访、失访报告等进行分析。结果:具有明确随机方法仅1篇占2%(1/64),有明确半随机方法3篇占5%(3/64),仅有1篇采用盲法,只有1篇运用空白对照,纳入/排除标准明确占6%,诊断标准明确占94%,疗效判定标准明确占100%,提及不良反应占12%,失访报告占3%,无一篇涉及随访和意向性分析。结论:按Jadad(Jadad1996)和Schulz(Schulz1995)提出的评价文献的质量标准,所调查的文献均存在高度偏倚,仅只有两个研究Jadad评分为2分。中国ILIB治疗CIS的RCTs/CCTs的质量有待进一步提高。     

氦氖激光血管内照射对慢性间断缺氧家兔血液流变学特性的影响

氦氖激光血管内照射对慢性间断缺氧家兔血液流变学特性的影响曹文新吴士明作者单位：４０００３７重庆，第三军医大学新桥医院理疗科低能量氦氖激光血管内照射是一项较新的弱激光治疗方法，在缺血性心脏病、脑血管病的治疗中已显示良好的临床应用价值［１］。研究表明，治...     

弱氦氖激光血管内照射治疗缺血性脑卒中临床试验文献评价

目的：了解中国弱氦氖激光血管内照射(intravaseular low lever He—Ne laser irradiation on blood，ILIB)治疗缺血性脑卒中(cerebral ischemic stroke．CIS)随机对照试验和临床对照试验(RCTs／CCTs)的现状，为其系统评价提供线索。方法：通过机检和手检获得发表的RCTs／CCTs共64篇，对献的随机化分配方法、盲法采用、样本含量、患纳入标准和排除标准、疗效判定标准、不良反应报告、治疗依从性、随访、失访报告等进行分析。结果：具有明确随机方法仅1篇占2％(1／64)，有明确半随机方法3篇占5％(3／64)，仅有1篇采用盲法，只有1篇运用空白对照，纳入／排除标准明确占6％，诊断标准明确占94％，疗效判定标准明确占100％，提及不良反应占12％，失访报告占3％，无一篇涉及随访和意向性分析。结论：按Jadad(Jadad1996)和Schulz(Schulz1995)提出的评价献的质量标准，所调查的献均存在高度偏倚，仅只有两个研究Jadad评分为2分。中国ILIB治疗CIS的RCTs／CCTs的质量有待进一步提高。     

低能量氦氖激光血管内照射治疗脑梗塞的护理

目的 探讨低能量氦氖激光血管内照射治疗脑梗塞患者的护理方法.方法 选择55例脑梗塞患者行低能量氦氖激光血管内照射治疗,并配合针对性的护理.于照射前后抽取空腹静脉血观察患者血液流变学指标的变化.结果 患者治疗后血液流变学的有关指标较治疗前均有不同程度的改善(P<0.05).结论 氦氖激光血管内照射治疗脑梗塞并配合针对性的护理,疗效满意,有利于患者早日康复.     

氦氖激光血管内照射治疗恢复期脑血管病的观察及护理体会

低能量氦氖激光血管内照射是由光导纤维将光导入静脉,对循环血液直接进行照射,产生一系列生物效应,以改善微循环,降低血黏度,具有良好的治疗效果,特别适用于心脑血管疾病方面。2006年5月～2007年5月,我科对75例恢复期脑血管病患者使用低能量氦氖激光血管内照射的康复治     

低能量氦氖激光血管内照射疗法的临床应用及护理

低能量氦氖激光血管内照射疗法的临床应用及护理５５０００２贵阳市第一人民医院陈亚宁，魏淑华低能量氦氖激光血管内照射疗法（ＩＬＩＢ）是国际上近年来发展起来的一种新兴治疗方法，它是将特定波长、特定能量的氦氖激光通过光纤、光针导入人体血管内，直接照射循环血液...     

低能量氦氖激光血管内照射治疗病毒性肝炎的临床观察及护理

应用低能量氦氖激光血管内照射治疗病毒性肝炎25例,通过临床观察,证明低能量氦氖激光血管内照射对于病毒性肝炎改善症状及肝功能恢复有一定的疗效,激光组与对照组比较,肝功能恢复平均缩短5.36天。     

低能量氦肠激光血管内照射治疗病毒性肝炎的临床观察及护理

应用低能量氦氖激光血管内照射治疗病毒性肝炎２５例，通过临床观察，证明低能量氦氖激光血管内照射对于病毒性肝炎改善症状及肝功能恢复有一定的疗效，激光组与对照组比较，肝功能恢复平均缩短５．３６天。     

氦氖激光血管内照射饲脂家兔血脂及电镜下主动脉内膜的变化

目的：探讨低能量氦氖激光血管内照射预防动脉粥样硬化的机制。方法：采用低能量氦氖激光血管内照射治疗饲脂家兔，观察其对家兔血脂和主动脉内膜及冠状动脉光镜及扫描电镜下病理学改变。结果：可明显降低血浆胆固醇、载脂蛋白Ｂ，升高载脂蛋白Ａ浓度，对甘油三酯无影响。减轻主动脉和冠状动脉内膜的灶状性增厚，减少单核细胞粘附。结论：低能量氦氖激光具有调节高脂家兔的血脂代谢，保护动脉内皮细胞功能，预防动脉粥样硬化的作用     

氦氖激光血管内照射治疗恢复期脑血管病的观察及护理体会

低能量氦氖激光血管内照射是由光导纤维将光导入静脉，对循环血液直接进行照射，产生一系列生物效应，以改善微循环，降低血黏度，具有良好的治疗效果，特别适用于心脑血管疾病方面。2006年5月～2007年5月，我科对75例恢复期脑血管病患者使用低能量氦氖激光血管内照射的康复治疗1个疗程后，患者症状恢复，效果显著。现报道如下。     

微波治疗宫颈糜烂随机对照试验的质量评价

目的评价微波治疗宫颈糜烂随机对照试验的方法学质量和报告质量。方法通过计算机检索、手工检索,全面收集与微波治疗宫颈糜烂有关的随机对照试验,按照Cochrane协作网推荐的评价方法对纳入研究进行方法学质量评价,按照CONSORT清单项目进行研究报告质量评价。结果最终纳入文献11篇,其中随机对照试验3篇,半随机对照试验8篇。评价结果显示,纳入文献方法学质量和报告质量普遍较低,其中C级为10篇, CONSORT评分最高仅17分。结论以往的微波治疗宫颈糜烂随机对照试验研究存在不同程度的方法学质量缺陷,故其结论存在发生选择性偏倚、实施性偏倚、测量性偏倚以及减员性偏倚的高度可能性。而低的研究报告质量又会严重影响读者对研究结果真实性、重要性及实用性的正确理解和评价。因此期待设计严密、实施科学、报告完整的随机对照研究出现。     

Clinical evidence of subcutaneous CO2 insufflations: a systematic review

OBJECTIVE: To evaluate the evidence of clinical effectiveness of subcutaneous CO2 insufflations (SCIs). STUDY LOCATION: The entire databases of MEDLINE, EMBASE Excerpta Medica (Field: Rehabilitation and Physical Medicine) and the Cochrane Library were screened for data up to August 1999. In addition, other potentially relevant journals were handsearched and references were checked. STUDY SELECTION: Uncontrolled observational trials (UCOTs) with sample sizes of at least n = 100, and controlled clinical trials (CCTs) and randomized controlled trials (RCTs) were included. Outcomes had to be patient-centered. English-, Czechoslovakian-, and German-language papers were considered. DATA ANALYSIS: For all study types, a criteria-based analysis was performed. For controlled trials only, quality was quantitatively assessed with the Jadad and Maastricht Scales. RESULTS: Thirteen studies (5 RCTs, 2 CCTs, and 6 UCOTs) were included. Mean scores on the Jadad and Maastricht Scales were 2 (Maximum 5) and 37 (Maximum 100), respectively. SCIs were found to be effective in addition to standard physical therapy in "peripheral arterial occlusive disease" (2 RCTs) and "stable angina pectoris" (1 RCT) and superior to sham needling for migraine headaches (1 RCT). There were no differences among SCIs and CO2 gas baths (1 RCT) or combined interventions, including SCIs (2 CCTs). All 6 UCOTs showed marked longitudinal effects. CONCLUSIONS: The low number and quality of the available studies precludes firm conclusions on the clinical effectiveness of SCIs.     

《北京中医药大学学报》临床治疗试验论文的评价

目的：了解《北京中医药大学学报》临床治疗试验论文的现状和水平,检索出其中属随机对照试验（RCTs）和临床对照试验（CCTs）的论文,为系统评价打基础。方法：按Cochrane中心手检指南逐篇查阅杂志论文。共检索从1981年～1998年共18卷102期杂志。结果：RCTs和CCTs论文占临床治疗试验论文的比例分别为19.42%、10.79%。RCTs论文90年代较80年代大幅增加,尤其近三年递增明显。CCTs论文比例无显著变化。结论：《北京中医药大学学报》临床治疗试验论文中RCTs、CCTs论文比例偏低,但近年来RCTs论文比例有大幅增加。论文撰写方面尚有许多不足需要改进。     

Acupuncture for schizophrenia: a systematic review and meta‐analysis

Background: Acupuncture is one of the most popular types of complementary/alternative medicine. It is sometimes used as a treatment for schizophrenia. Aims: The objective of this review is to assess systematically the clinical evidence for or against acupuncture as a treatment for schizophrenia. Methods: We searched 20 databases from their inception to May 2009 without language restrictions. All randomised clinical trials (RCTs) of acupuncture, with or without electrical stimulation or moxibustion for patients with schizophrenia were considered for inclusion. Results: Thirteen RCTs, all originating from China, met the inclusion criteria. One RCT reported significant effects of electroacupuncture (EA) plus drug therapy for improving auditory hallucunations and positive symptom compared with sham EA plus drug therapy. Four RCTs showed significant effects of acupuncture for response rate compared with antipsychotic drugs [n = 360, relative risk (RR): 1.18, 95% confidence interval (CI): 1.03–1.34, p = 0.01; heterogeneity: τ² = 0.00, χ² = 2.98, p = 0.39, I² = 0%]. Seven RCTs showed significant effects of acupuncture plus antipsychotic drug therapy for response rate compared with antipsychotic drug therapy (n = 457, RR: 1.15, 95% CI: 1.04–1.28, p = 0.008, heterogeneity: τ² = 0.00, χ² = 6.56, p = 0.36, I² = 9%). Two RCTs tested laser acupuncture against sham laser acupuncture. One RCT found beneficial effects of laser acupuncture on hallucination and the other RCT showed significant effects of laser acupuncture on response rate, Brief Psychiatric Rating Scale and clinical global index compared with sham laser. The methodological quality was generally poor and there was not a single high quality trial. Conclusion: These results provide limited evidence for the effectiveness of acupuncture in treating the symptoms of schizophrenia. However, the total number of RCTs, the total sample size and the methodological quality were too low to draw firm conclusions. As all studies originated from China, international studies are needed to test whether there is any effect.     

《护士进修杂志》随机对照临床试验文献评价

目的 了解《护士进修杂志》从1986年创刊以来刊登的临床护理论文中的随机对照试验（RCTs)和半随机对照试验（CCTs)论文的数量和质量，向中国Cochrane中心输送基线资料，同时了解护理工作者临床科研设计和论文撰写能力的现状，方法 按Cochrane中心手检指南对该杂志15卷180期的护理论文进行手检结果：共检出临床护理论文5297篇，其中属RCTs121篇，占2.3%，CCTs121篇，占2.3%。结果 RCTs论文从90年代开始逐年增加，尤以近五年递增明显，临床护理论文的数量也呈逐年增加趋势，说明广大护理工作者参与护理研究的意识增强，撰写论文的积极性在提高，RCTs121篇论文中，仅5篇阐明有具体随机方法（随机数字表），占4.1%,在CCTs121篇论文中，采用半随机分配法有22篇，占18.1%，其余论文采用非随机分组者占81.9%，结论 说明在RCTs和CCTs中有许多不足，有待改进。     

<江苏中医>随机对照临床治疗试验文献评价--1980～1998手检分析

目的：评价《江苏中医》从1980年至1998年间临床治疗试验中随机对照试验（RCT）的论文质量,并向中国Cochrane中心输送基线资料。方法：逐期逐页手工检索《江苏中医》1980年至1998年中发表的临床治疗性研究的对照试验。根据“国际Cochrane协作网工作手册1997“对RCT和临床对照试验（CCT）的定义严格鉴定RCT和CCT。结果：在19卷198期中共刊登临床试验论文2024篇,其中RCTs149篇（7.36%),盲法3篇（占RCTs的2.01%）,CCTs136篇（6.72%)。RCT论文呈逐年趋势。1990年以后高于1990年以前,尤以1995年以后为甚。结论：《江苏中医》刊登RCT论文呈逐年增加,但也存在一些问题,RCT样本量较小,且不规范,盲法采用率较低。RCT质量仍有待提高。     

Nonsurgical treatment of tennis elbow]

OBJECTIVE: To review the literature on nonsurgical treatment of tennis elbow. METHODS: We searched Medline for all randomized controlled trials (RCTs), controlled clinical trials (CCTs) and literature reviews published from 1966 to December 2003 on nonsurgical treatment of tennis elbow. We used the keys words controlled clinical trial, tennis elbow on lateral epicondylitis, and treatment. We found 46 reports of RCTs and CCTs on 14 nonsurgical treatments and 11 literature reviews. RESULTS: Corticosteroid injection is the best treatment option for the short term. However, beneficial effects persisted only for a short time, and the long-term outcome could be poor. For the long term, physiotherapy (pulsed ultrasound, deep friction massage and exercise programme) was the best option but was not significantly different from the "wait-and-see" approach. Some support is offered for the use of topical nonsteroid anti-inflammatory drugs, at least for the short term. There is insufficient evidence to support or refute the use of acupuncture, extracorporeal shock wave therapy, manipulation, orthoses, low-energy laser, glycosaminoglycan polysulfate injection, botulinum toxin injection, or topical nitric oxide application. CONCLUSION: Further trials, with use of appropriate methods and adequate sample sizes, are needed before conclusions can be drawn about the effects of many of the treatments for tennis elbow and their ability to change the condition's natural course.     

《中国中西医结合急救杂志》随机对照临床试验文献评价

目的：通过评价《中国中西医结合急救杂志》临床治疗试验中随机对照试验(RCT)的论文数量，了解中西医结合急救医学中科研设计的方法学现状，并向中国Cochrane中心输送基线资料。方法：对《中国中西医结合急救杂志》1994—2001年中发表的临床研究文献进行逐期逐页手工检索，并根据《国际Cochrane协作网工作手册1997》对RCT和临床对照试验(CCT)的定义严格鉴定RCT和CCT。结果：在8卷67期中共刊登临床试验论文1606篇，其中RCT文章618篇(38．48％)，CCT文章203篇(12．64％)，RCT论文比例呈逐年增加趋势，尤以1998年以后为甚，2000年比例甚至达到60．32％。结论：《中国中西医结合急救杂志》刊登RCT论文呈逐年增加，说明中西医结合急救医学已经逐渐从经验医学向循证医学转变。     

Systematic review of randomized controlled trials of nonpharmacological interventions for fibromyalgia

OBJECTIVE: Little is known of the effectiveness of nonpharmacological interventions for fibromyalgia syndrome (FMS). The authors therefore carried out a systematic review from 1980 to May 2000 of randomized controlled trials (RCTs) of nonpharmacological interventions for FMS. METHOD: A search of computerized databases was supplemented by hand searching of bibliographies of key publications. The methodological quality of studies included in the review was evaluated independently by two researchers according to a set of formal criteria. Discrepancies in scoring were resolved through discussion. RESULTS: The review yielded 25 RCTs, and the main categories of interventions tested in the studies were exercise therapy, educational intervention, relaxation therapy, cognitive-behavioral therapy, acupuncture, and forms of hydrotherapy. Methodological quality of studies was fairly low (mean score = 49.5/100). Most studies had small samples (median for individual treatment groups after randomization = 20), and the mean power of the studies to detect a medium effect ( > or = 0.5) was 0.36. Sixteen studies had blinded outcome assessment, but patients were blinded in only 6 studies. The median longest follow-up was 16 weeks. Statistically significant between-group differences on at least one outcome variable were reported in 17 of the 24 studies. CONCLUSIONS: The varying combinations of interventions studied in the RCTs and the wide range of outcome measures used make it hard to form conclusions across studies. Strong evidence did not emerge in respect to any single intervention, though preliminary support of moderate strength existed for aerobic exercise. There is a need for larger, more methodologically rigorous RCTs in this area.