针刺治疗广泛性焦虑障碍疗效和安全性的Meta分析

目的 应用Meta分析评价针刺治疗广泛性焦虑障碍临床疗效及安全性。方法 检索自建库至2022年5月1日的中英文数据库中关于针刺治疗广泛性焦虑障碍的随机对照试验，进行筛选、纳入及文献风险评估。应用Stata 16、Review Manager 5.4软件对不同结局指标和（或）干预措施进行Meta分析及亚组分析。结果 最终纳入20篇随机对照试验文献，包含病例数1661例，4种干预措施（针刺+电针、针刺、电针、西药）。Meta分析结果提示采用随机效应模型，针刺组对比西药组治疗在汉密尔顿焦虑量表（Hamilton anxiety scale，HAMA）、焦虑自评量表（self-rating anxiety scale，SAS）评分差异均有统计学意义（P<0.05）。亚组分析结果显示：针刺组较阿普唑仑在HAMA评分差异有统计学意义；针刺组较单纯帕罗西汀、丁螺环酮、氯羟去甲安定/谷维素/心得安在SAS评分差异有统计学意义。在不良反应量表评定上，针刺（包括电针）组较西药组差异有统计学意义（P<0.01）。结论 针刺（包括电针）可以有效改善焦虑情绪及症状，疗效不亚于西药，且具有不良反应少、安全性较高等优势。但纳入文献的数量不足、质量不高，仍需多中心、大样本、高质量的随机对照研究进一步印证以上结论。

Efficacy and safety of acupuncture in the treatment of grand anxiety disorder: a Meta-analysis

Objective To evaluate the clinical efficacy and safety of acupuncture in the treatment of grand anxiety disorder by applying Meta-analysis. Methods Randomized controlled trials on acupuncture treatment of generalized anxiety disorder in 7 Chinese and English databases from the establishment of the database to May 1, 2022 were searched for screening, inclusion and literature risk assessment. Meta-analysis and subgroup analysis of different outcome indicators and/or intervention measures were performed using Stata 16 and Review Manager 5.4 software. Results Finally, 20 randomized controlled trials were included, including 1661 cases and 4 intervention measures (acupuncture+electroacupuncture, acupuncture, electroacupuncture and western medicine). The results of meta-analysis indicated that there were statistically significant differences in HAMA and SAS scores between acupuncture group and western medicine group (P<0.05). The results of subgroup analysis showed that there was statistically significant difference in Hamilton anxiety scale (HAMA) score between acupuncture group and alprazolam. There was a statistically significant difference in self-rating anxiety scale (SAS) score between acupuncture group and simple paroxetine, buspirone, chlorhexidine/oryzanol/propranolol. In the evaluation of side effect scale, the difference between acupuncture (including electroacupuncture) group and western medicine group was statistically significant (P<0.01). Conclusion Acupuncture (including electroacupuncture) can effectively improve anxiety and symptoms with efficacy no less than that of Western medicine, and has the advantages of fewer adverse effects and higher safety. However, due to the quantity and quality of the included literature, multi-center, large sample, and high-quality randomized controlled studies are still needed to further corroborate the above conclusions.