头针治疗帕金森病：一项随机对照试验的系统评价

Objective: To evaluate the effectiveness of scalp acupuncture (SA), a modern acupuncture technique specialized to neurological disorders, in managing motor function and symptoms for Parkinson''s disease (PD) patients. Methods: Two independent reviewers extracted data from all of the randomized clinical trials (RCTs) that assessed the efficacy of SA for PD compared with conventional therapies (CTs). Sixteen electronic databases were searched. The risk of bias was appraised with the Cochrane Collaboration tool, and the reporting of the included studies was evaluated by the Consolidated Standards of Reporting Trials (CONSORT) 2010 checklist and the revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines. Results: In total, 4 RCTs met the inclusion criteria. As assessed by the Unified PD Rating Scale (UPDRS), 2 RCTs showed that SA combined with CTs proved superior to CTs alone [60 cases; weighted mean difference, –3.94; 95% confidence interval (CI), –6.05 to –1.84, P=0.01; I2=0%]. Based on the Webster scale, however, 3 RCTs showed no superior effect of SA when combined with CTs with high heterogeneity (154 cases; risk ratio, 1.29; 95% CI, 0.79 to 2.12, P=0.30; I2=84%). The Cochrane risk of bias, adherence to the CONSORT and the STRICTA checklist showed that the quality of all the included RCTs was generally low. Conclusions: The result of our systematic review and meta-analysis suggested that the effectiveness of SA for PD is promising, however, the evidence is not convincing. A sham-controlled RCT design that adheres to the CONSORT and STRICTA guidelines to overcome methodological weakness and that includes a large sample size is strongly recommended to confirm the precise effect of SA on PD.     

Ginkgo Leaf Extract and Dipyridamole Injection as Adjuvant Treatment for Angina Pectoris: A Meta-Analysis of 41 Randomized Controlled Trials

Objective: To provide information about the effectiveness and safety of Ginkgo Leaf Extract and Dipyridamole Injection(GD) as one adjuvant therapy for treating angina pectoris(AP) and to evaluate the relevant randomized controlled trials(RCTs) with meta-analysis. Methods: RCTs concerning AP treated by GD were searched in China Biology Medicine Disc(SinoMed), PubMed, the China National Knowledge Infrastructure Database(CNKI), the Chinese Scientific Journals Database(VIP), Wanfang Database, Embase, and the Cochrane Library, from inception to February, 2017. The Cochrane Risk Assessment Tool was adopted to assess the methodological quality of the RCTs. The Review Manager 5.3 software was utilized to conduct the meta-analysis. Results: A total of 41 RCTs involving 4,462 patients were included in the meta-analysis. The results indicated that the combined use of GD and Western medicine(WM) against AP was associated with a higher total effective rate [risk ratio(RR)=1.25, 95% confidence interval(CI): 1.21–1.29, P0.01], total effective rate of electrocardiogram(RR=1.29, 95% CI: 1.21–1.36, P0.01). Additional, GD combined with WM could decrease the level of plasma viscosity [mean difference(MD)=–0.56, 95% CI: –0,81 to –0.30, P0.01], fibrinogen [MD=–1.02, 95% CI: –1.50 to –0.54, P0.01], whole blood low shear viscosity [MD=–2.27, 95% CI: –3.04 to –1.49, P0.01], and whole blood high shear viscosity(MD=–0.90, 95% CI: 1.37 to –0.44, P0.01). Conclusions: Comparing with receiving WM only, the combine use of GD and WM was associated with a better curative effect for patients with AP. Nevertheless, limited by the methodological quality of included RCTs more large-sample, multi-center RCTs were needed to confirm our findings and provide further evidence for the clinical utility of GD.     

Evaluation on Effectiveness and Safety of Chinese Herbs in Treatment of Sub-health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective: To evaluate the effectiveness and safety of Chinese herbs in the treatment of sub-health systematically. Methods: Nine databases were systematically and extensively searched to collect randomized controlled trials (RCTs) about Chinese herbs in the treatment of sub-health. The outcomes included overall effective rate, main symptoms, quality of life, etc. Literature screening, data extraction and quality assessment were conducted according to Cochrane Handbook 5.1. Meta-analysis was conducted to the included literature with Review Manager Software. Results: Seventy-two studies involving 9,296 patients with sub-health were included with 4,908 patients in experimental groups and 4,387 patients in control groups. The overall quality of included clinical research was not high. In the aspect of improving overall effective rate, relieving main symptoms, Pittsburgh sleep quality index (PSQI) score, Athens Insomnia Scale (AIS) score, Fatigue Scale-14 (FS-14), Cornell Medical Index (CMI) score and discontinuation rate, the effects of experimental groups were better than that of control groups. According to available research reports, adverse reactions in Chinese herb groups were mainly mild gastrointestinal symptoms, which did not affect the treatment. Conclusion: Chinese herbs have a curative effect in the treatment of sub-health. However, there are no clear criteria for diagnosis and curative effectiveness judgment globally, which would affect the accuracy of curative effect evaluation.     

Blood-Letting Therapy for Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective: To evaluate the efficacy and safety of blood-letting therapy (BLT) in treatment of hypertension. Methods: A comprehensive electronic and manual bibliographic searches were performed in Cochrane Central Register of Controlled Trials, Excerpt Medica Database (EMBASE), PubMed, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Chinese Biomedical Literature Database, and Wanfang Database to identify randomized controlled trials (RCTs) in which hypertensive patients were treated with BLT or BLT plus antihypertensive drugs (BPAD) against placebo, no treatment or antihypertensive drugs. The Cochrane Risk Assessment Tool was used to assess the methodological quality of trials. The Review Manager 5.3 software was used for meta-analysis. Results: A total of 7 RCTs with 637 hypertensive patients from 1989 to 2017 were identified. Compared with antihypertensive drugs, blood pressure was significantly reduced by BLT (RR=1.21, 95% CI: 1.01 to 1.44, P=0.03; heterogeneity: P=0.06, I2=60%) and BPAD (RR=1.25, 95% CI, 1.02 to 1.53, P=0.03; heterogeneity: P= 0.01, I2=71%). Moreover, a significant improvement in Chinese medicine syndrome by BLT (RR=1.32; 95% CI: 1.14 to 1.53, P=0.0002; heterogeneity: P=0.53, I2=0%) and BPAD (RR=1.47; 95% CI: 1.06 to 2.04, P=0.02; heterogeneity: P=0.13, I2=56%) was identified. The reported adverse effects were well tolerated. Conclusions: Although some positive findings were identified, no definite conclusions regarding the efficacy and safety of BLT as complementary and alternative approach for treatment of hypertension could be drew due to the generally poor methodological design, significant heterogeneity, and insufficient clinical data. Further rigorously designed trials are warranted to confirm the results.     

尿毒清治疗慢性肾脏病的系统评价

目的:评价尿毒清治疗慢性肾脏病的疗效和安全性。方法:收集使用尿毒清治疗慢性肾脏病的随机对照试验(RCT)。按纳入排除标准筛选试验、评价研究质量、提取有效数据,并采用Revman5.0进行统计分析。结果:共纳入27个RCT,均以中文发表,纳入文献质量均为C级。在常规治疗基础上,尿毒清在临床疗效和肾功能改善方面与空白对照比较差异有统计学意义;在改善血尿素氮和内生肌酐清除率方面与包醛氧淀粉比较差异有统计学意义;在改善血清肌酐方面与包醛氧淀粉没有统计学差异。尿毒清与其他中药(云南灯盏花胶囊、益肾宁方等)比较,在临床疗效、肾功能改善、24h尿蛋白、血压改善方面多不及其它中药。结论:由于纳入试验方法学质量普遍较低,缺乏必要的终点指标,尿毒清治疗慢性肾脏病的疗效及安全性尚不能确定,需开展大样本、高质量、设计合理的随机对照试验进一步证实。     

Chinese Medicine for Alzheimer's Disease: A Meta-Analysis of Randomized Controlled Trials

Objective: To evaluate the efficacy of oral Chinese medicine(CM) in comparison with donepezil, a cholinesterase inhibitor(ChEI), for the treatment of Alzheimer's disease(AD). Methods: Randomized controlled trials(RCTs) have been searched, and the effect of CM compared with donepezil in AD has been investigated. An electronic search of MEDLINE, Excerpta Medica Database(EMBASE), Cochrane Library, Chinese Biological Medicine Database(CBMdisc), and China National Knowledge Infrastructure(CNKI) to identify articles in English and Chinese from the inception of the database until October 18, 2015. A modified Jadad score(7-points) to judge the methodological quality of studies, comprehensive meta-analysis was performed with Cochrane Collaboration Revman 5.3. Dichotomous data were analyzed by relative risk(RR) with a 95% confidence interval(CI), while continuous variables were analyzed by using mean differences(MD) with 95% CI for effect size. Results: Six studies involving 596 AD patients through Jadad assessment with low bias were included in the meta-analysis. No significant difference was observed in cognitive improvement and daily abilities of patients using the Mini Mental State Examination(MMSE)(MD: 0.69, 95% CI: –0.17 to 1.56) and Activities of Daily Living(ADL) scale(MD: 0.94, 95% CI: –1.54 to 3.43). There were no significant differences in status of illness or MD for mild-moderate AD patients at 24 weeks(MD: 0.62, 95% CI: –2.99 to 4.23) and 48 weeks(MD: –0.73, 95% CI: –5.02 to 3.56). Severe AD patients were also assessed at 24 weeks(MD: 3.13, 95% CI: –6.92 to 13.18) and 48 weeks(MD: 4.23, 95% CI: –6.38 to 14.84). Furthermore, compared with donepezil, Xin(Heart)-regulating CM and Shen(Kidney)-tonifying groups were observed(MD: –1.50, 95% CI: –3.08 to 0.08; MD: –1.92, 95% CI: –3.50 to –0.33; respectively). CM had fewer side effects in AD patients. Conclusion: Compared with donepezil, oral CM showed no significant difference in effectiveness in AD patients, and more evidence is needed to verify the findings.     

针灸治疗糖尿病胃轻瘫随机对照试验文献质量评价

目的对针灸治疗糖尿病胃轻瘫随机对照试验文献质量进行分析,为进一步的临床试验研究提供参考。方法检索近30年针灸治疗糖尿病胃轻瘫临床研究文献,采用循证医学的原则及评价方法,制定临床文献评价及信息采集表,对纳入文献进行分析和评价。结果检索到符合纳入标准的临床对照试验文献21篇,在样本量估算、疾病诊断标准及疗效判定标准、盲法和分配隐藏、随机化实施、随访及病例脱失剔除情况、结局指标选择、安全性观察、结论推导等方面存在一些问题。结论针灸治疗糖尿病胃轻瘫的临床研究文献存在样本量较少、研究方法实施不严谨、结局指标选取不统一的缺点,尚不能得出针灸优于其他疗法的确切结论,故有必要进一步做多中心、大样本及高质量的临床试验研究。     

针灸复合全身麻醉干预麻醉药用量的系统评价和Meta分析

目的：系统评价针灸复合麻醉对术中麻醉药使用量、苏醒时间、心率和平均动脉压的干预效应。方法由2人按制定的检索策略独立对7个电子数据库进行文献检索,以临床研究为单位,辅以手工检索相关文献;按研究纳入和排除标准筛选符合要求针灸辅助麻醉临床试验;根据Cochrane Handbook指导2人独立使用RevMan对每个符合纳入标准的临床试验进行偏倚风险和文献质量评估,并提取纳入研究的对象、方法和结果等资料;选取术中维持一定麻醉深度所使用的麻醉药品总量作为主要指标,术中心率和平均动脉压及术后苏醒时间为次要指标,条件符合时采取Meta分析。结果最终纳入12项研究,包括979名患者,静脉麻醉药丙泊酚用量均数差值（MD）和95%置信区间（CI）为-59.29[-91.92,-26.67];吸入麻醉药用量标准化均数差值（SMD）和95% CI为-2.34[-3.60,-1.09];苏醒时间MD和95% CI为-4.31[-4.52,-4.10];全麻过程中各时间点心率和平均动脉压95% CI均跨越无效线。结论针灸复合全身麻醉与常规全身麻醉相比,能减少麻醉药品使用量和缩短麻醉苏醒时间,对心率和平均动脉压无明显影响。     

针灸治疗糖尿病胃轻瘫随机对照试验文献质量评价

目的 对针灸治疗糖尿病胃轻瘫随机对照试验文献质量进行分析,为进一步的临床试验研究提供参考.方法 检索近30年针灸治疗糖尿病胃轻瘫临床研究文献,采用循证医学的原则及评价方法,制定临床文献评价及信息采集表,对纳入文献进行分析和评价.结果 检索到符合纳入标准的临床对照试验文献21篇,在样本量估算、疾病诊断标准及疗效判定标准、盲法和分配隐藏、随机化实施、随访及病例脱失剔除情况、结局指标选择、安全性观察、结论推导等方面存在一些问题.结论 针灸治疗糖尿病胃轻瘫的临床研究文献存在样本量较少、研究方法实施不严谨、结局指标选取不统一的缺点,尚不能得出针灸优于其他疗法的确切结论,故有必要进一步做多中心、大样本及高质量的临床试验研究.     

Conventional Acupuncture for Cardiac Arrhythmia: A Systematic Review of Randomized Controlled Trials

Objective:To exam the effect and safety of conventional acupuncture(CA) on cardiac arrhythmia.Methods:Nine medical databases were searched until February 2016 for randomized controlled trials.Heterogeneity was measured by Cochran Q test.Meta-analysis was conducted if I2 was less than 85% and the characteristics of included trials were similar.Results:Nine qualified studies involving 638 patients were included.Only 1 study had definitely low risk of bias,while 7 trials were rated as unclear and 1 as high.Meta-analysis of CA alone did not have a significant benefit on response rate compared to amiodarone in patients with atrial fibrillation(Af) and atrial flutter(AF) [relative risk(RR):1.09;95% confidence interval(CI):0.79–1.49;P=0.61;I2=61%,P=0.11].However,1 study with higher methodological quality detected a lower recurrence rate of Af in CA alone as compared with sham acupuncture plus no treatment,and benefits on ventricular rate and time of conversion to normal sinus rhythm were found in CA alone group by 1 study,as well as the response rate in CA plus deslanoside group by another study.Meta-analysis of CA plus anti-arrhythmia drug(AAD) was associated with a significant benefit on the response rate when compared with AAD alone in ventricular premature beat(VPB) patients(RR,1.19,95% CI:1.05–1.34;P=0.005;I2=13%,P=0.32),and an improvement in quality-of-life score(QOLS) of VPB also showed in 1 individual study.Besides,a lower heart rate was detected in the CA alone group by 1 individual study when compared with no treatment in sinus tachycardia patients(MD –21.84 [–27.21,–16.47]) and lower adverse events of CA alone were reported than amiodarone.Conclusions:CA may be a useful and safe alternative or additive approach to AADs for cardiac arrhythmia,especially in VPB and Af patients,which mainly based on a pooled estimate and result from 1 study with higher methodological quality.However,we could not reach a robust conclusion due to low quality of overall evidence.     

针灸治疗肌腱病患者运动功能康复疗效的Meta分析

目的 系统评价针灸治疗肌腱病患者运动功能康复的临床疗效.方法 检索EMbase、Pubmed、The Cochrane library、中国知网(CNKI)、万方数据、中国生物医学文献数据库(CBM)等数据库自建库起至2019年3月针灸治疗肌腱病临床疗效和安全性的随机对照试验(RCT),提取纳入文献的基本资料并评价其质...     

针刺治疗脑卒中后吞咽障碍临床研究进展简

该文回顾近年来针刺治疗脑卒中后吞咽障碍的不同治疗方法,并从现代医学角度对其机理进行分析,认为针刺治疗脑卒中后吞咽障碍具有肯定临床疗效。同时指出该病临床研究存在的问题及未来发展方向。     

术中辅助性腹腔内温热灌注化疗在胃癌治疗中应用的Meta 分析

目的：比较术中辅助性腹腔温热灌注化疗在胃癌治疗中的安全性及有效性。方法：计算机检索中国知网、Pubmed、ScienceDirect、Highwire等数据库1998-2010年有关术中应用辅助性腹腔内温热灌注化疗与否的随机对照试验（RCT）。评价纳入研究的质量后,提取有效数据,采用ReviewManager4.2软件进行Meta分析。结果：经过筛选10篇文章纳入分析,其中9篇用于胃癌根治术后生存率的分析,6篇用于局部腹腔转移率的分析;8篇用于术后并发症的分析;共1435例胃癌根治术。Meta分析结果示：术中灌注化疗组与非化疗组术后并发症无统计学意义。术中腹腔内温热温灌注化疗明显改善患者的三年生存率 ( OR = 0.54, 95% CI = 0.36-0.81, P = 0.003 ),同时能够降低术后患者的局部复发（OR= 0.34, 95%CI= 0.23-0.48, P<0.01）。结论：术中腹腔内温热灌注化疗能降低胃癌患者的局部复发率,提高三年生存率。     

TVT治疗单纯性女性压力性尿失禁临床疗效的荟萃分析

目的 对经阴道无张力性尿道中段悬吊术（TVT）治疗女性压力性尿失禁的客观成功率和并发症发生率进行荟萃分析。方法计算机并配合手工检索PubMed、EMBASE及中国生物医学文献数据库（CBMdisc）、中国期刊全文数据库、万方数据库和相关会议中所有对比TVT和膀胱颈悬吊术（Burch）疗效的临床随机对照试验，进行质量评价后用RevMan4．2软件进行荟萃分析，主要分析客观成功率、并发症率。结果共纳入7个随机对照试验。Meta分析结果显示：1年以上，TVT客观成功率高于Burch（RR为1．12，95％可信区间1．02-1．22，P〈0．05）；术后1年以内．TVT和Burch客观成功率相似（RR为1．03，95％可信区间0．95～1．12，P〉0．05）。TVT组客观成功率与“金标准”术式开腹Burch相似（RR为1．01，95％可信区间0．92～1．11，P〉0．05），并发症率低于微创术式腹腔镜Burch（RR为0．49．95％可信区间0．31-0．77，P〈0．05）。结论 TVT是一种疗效可靠、并发症少的治疗女性压力性尿失禁的微创术式。     

针灸与西药治疗脑卒中后抑郁症疗效比较的系统评价

目的比较针灸与西药治疗脑卒中后抑郁症的有效性和安全性。方法电子检索CBMdisc（1978—2009年）、CNKI（1979—2009年）、VIP（1989—2009年）和万方（1998—2009年）、PubMed（1966—2009年）、EMBASE（1980—2009年）数据库和Cochrane Library（Issue4,2008）数据库。并辅以手工检索。收集相关随机对照试验,由2名评价者独立提取资料并按照Cochrane Review Handbook5．0进行质量评估。统计学分析采用RevMan5．0．20软件。结果共纳入20篇随机对照试验,共有2031例。Meta分析结果显示：（1）有效率（24项HAMD减分率）,针灸VS．盐酸氟西汀在第8周时有差别[相对危险度1．15,95％可信区间（1．07,1．24）],在第4、6周时没有差别。（2）有效率（17项HAMD减分率）,针灸vs．盐酸氟西汀或阿米替林无差别。（3）24项HAMD评分情况,针灸vs．盐酸氟西汀在第1、4周时有差别[加权均数差-3．80,95％可信区间（-7．64,0．04）、加权均数差-1．34,95％可信区间（-2．67,-0．02）],在第2、6、8、24周均无差别;针灸VS．阿米替林有差别。（4）17项HAMD评分情况,针灸vs．盐酸氟西汀在第4周有差别[加权均数差-1．15,95％可信区间（-2．01,-0．30）],在第2、6周时没有差别;针灸vs．阿米替林没有差别。（5）抑郁自评量表评分情况,针灸vs．盐酸氟西汀或阿米替林有差别。（6）安全性,共有12项试验报道了不良反应情况,其中有2项试验分别采用TESS评分和SERS评分量表,其余为描述性分析,均显示针灸组不良反应要少于西药组。结论针灸治疗脑卒中后抑郁症的疗效与西药相比,优势尚不能确定,但不良反应少,需要更多高质量的随机对照试验来进一步证实。     

体针治疗中风后抑郁症Meta分析

目的:对体针治疗中风后抑郁症的文献进行质量评价。方法:计算机检索中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和万方数据库,收集公开发表的所有关于针刺治疗中风后抑郁症的随机对照试验。检索年限为2000年1月1日—2014年5月1日。按照纳入、排除标准筛选文献并评价文献研究质量,应用Rev Man5.3软件进行Meta分析。结果:共纳入27篇随机对照试验,对照组均为百忧解,治疗组为体针的20篇,治疗组为体针结合百忧解的7篇。Meta分析结果显示,体针组治疗中风后抑郁优于百忧解组[MD=0.84,95%CI(0.27,1.45),P=0.004],体针结合百忧解治疗中风后抑郁症也优于百忧解组[MD=3.66,95%CI(0.38,6.94),P=0.003]。结论:针刺治疗中风后抑郁症疗效优于百忧解,但是仍需要更多大样本、设计严谨的随机对照试验来证实。     

针灸治疗麻痹性斜视系统评价

目的:评价针灸治疗麻痹性斜视的临床疗效及安全性。方法:计算机检索Cochrane Library(Issue 1,2011)、PubMed(1980—2011.7)、MEDLINE(1966—2011)、Ovid循证医学数据库(1991—2011),中国生物医学文献数据库(CBMdisc,1978—2011.7)、中国期刊全文数据库(CNKI,1979—2011.7)、维普期刊全文数据库(VIP,1989—2011.7)和万方数据资源系统(1983—2011.7),同时手工检索4种中医杂志,检索时间均为2010.1—2011.8,语言限于中英文,收集针灸治疗麻痹性斜视的临床随机对照试验(RCT),参照Cochrane系统评价员手册5.1.0推荐的对偏倚风险的评价工具进行文献质量评价,并采用RevMan 5.0软件进行Meta分析。结果:最终纳入5个RCT,均为低质量研究,共301例患者,Meta分析结果显示,两组有效率的差异有统计学意义[RR=1.30,95%C(I1.09,1.54)],针灸配合药物治疗麻痹性斜视的疗效优于单纯使用药物。结论:针灸治疗麻痹性斜视有一定疗效,但由于纳入试验质量均较低,仍需高质量的随机对照试验来确定针灸治疗麻痹性斜视的疗效。     

通窍活血汤治疗偏头痛随机对照试验系统评价

目的:系统评价通窍活血汤治疗偏头痛的临床疗效及安全性。方法:通过文献检索,搜集通窍活血汤治疗偏头痛的随机对照试验,以通窍活血汤为试验组,西药治疗为对照组,按照Cochrane协作网推荐的方法评估纳入研究的偏倚风险,运用RevMan 5.3软件完成异质性检验、Meta-分析、敏感性分析、倒漏斗图分析等相关统计学分析。结果:共纳入合格研究15项,涉及患者1 367例。Meta-分析结果显示通窍活血汤治疗偏头痛在总有效率、减少不良反应方面与西药比较,具有明显优势,RR=1.36,95%CI[1.28,1.43],结果具有统计学意义(P0.00001);敏感性分析提示该结果稳定性较好;通窍活血汤在治疗过程中不良反应较少;倒漏斗图分析显示不对称。结论:就现有证据表明,通窍活血汤治疗偏头痛疗效较为突出,且相对西药更为安全,但纳入的文献偏倚风险较高。因此,在随机对照试验的临床应用中,应更加注重方法学的完善,并为临床决策用药提供可靠证据。     

Astragalus Membranaceus Injection Combined with Conventional Treatment for Viral Myocarditis: A Systematic Review of Randomized Controlled Trials

Objective：To assess the efficacy and safety of Astragalus membranaceus Injection combined with conventional therapy in the treatment of viral myocarditis.Methods：Randomized controlled trials（RCTs） of A.membranaceus Injection combined with conventional treatment compared with conventional treatment alone were included.Study population characteristics and outcome results were extracted independently by two assessors.Meta-analysis was performed for data available.Results：Six RCTs,involving 639 participants,were included in this study.The methodological quality of the included trials was generally low,and there was high risk of publication bias in the included trials.The total effective rate of A.membranaceus Injection combined with conventional treatment was significantly higher than that of conventional treatment alone.Compared with conventional treatment,the cointervention treatment group showed significant recovery in myocardium enzyme levels and electrocardiography.Two RCTs reported there were no adverse effects from A.membranaceus Injection combined with conventional treatment.Conclusion：A.membranaceus Injection combined with conventional treatment appeared to be more efficacious compared with conventional treatment alone for treating viral myocarditis.However,this conclusion should be cautiously interpreted due to low methodological quality,small sample size,limited number of trials,and high risk of publication bias and other unidentified risks of bias.The safety of A.membranaceus Injection combined with conventional treatment remains uncertain.     

针刺治疗慢性紧张型头痛随机对照研究

目的观察毫针治疗慢性紧张型头痛的临床疗效。方法应用随机数字表法将研究对象分为治疗组、对照组共纳入50例病人,治疗组27例,对照组23例,完成随访46例。治疗组针刺头部和辨证远端穴位,对照组接受安慰针刺加服艾司唑仑。针刺治疗每周3次,连续治疗4周,艾司唑仑0.5mg每晚睡前服用,连续4周。16周后进行随访。结果治疗组随机分组后第4周、16周时,在头痛天数变化率、头痛天数、头痛时间方面疗效优于对照组(P<0.05),在生活质量改善方面,治疗组仅在2个维度(社会功能、健康状况)得分上优于对照组(P<0.05),在头痛程度、情绪及生活质量等其他6个维度的改善方面组间差异无统计学意义。结论针刺治疗慢性紧张型头痛安全、不良反应小,疗效优于安慰针刺加服小剂量艾司唑仑。