针刺治疗心脏神经官能症疗效的Meta分析

目的:系统评价针刺治疗心脏神经官能症的临床疗效。方法:检索国家知识基础设施数据库（CNKI）、中国学术期刊数据库（CSPD）、中文科技期刊数据库（CCD）、中国生物医学文献数据库（CBM）、Pubmed，按照纳入与排除标准纳入单独针刺与西药比较、针刺联合常规西药与西药比较治疗心脏神经官能症的随机对照试验（RCT），检索年限均为建库至2020年1月25日。提取数据，采用Cochrane协作网推荐的评价标准对纳入试验进行质量评价、Rev Man5.3软件进行Meta分析。结果:纳入15篇RCT，总计1 344例患者。Meta分析结果提示，针刺治疗总有效率优于对照组（RR=1.28，95%CI为1.21～1.35,P<0.01），单纯针刺治疗的总有效率亦优于对照组（RR=1.25，95%CI为1.17～1.34,P<0.01）。针刺可有效改善汉密尔顿焦虑量表(HAMA) 评分（WMD＝-4.10，95%CI为-4.58～-3.61,P<0.000 1）及汉密尔顿抑郁量表(HAMD)评分（WMD＝-4.62，95%CI为-5.30～-3.93,P<0.000 01）。结论:针刺治疗心脏神经官能症优于常规西药，但受纳入研究数量较少、质量偏低的限制，以上结论须待开展更多高质量RCT予以验证。

Efficacy of Acupuncture in the Treatment of Cardiac Neurosis:a Meta-analysis

To systematically evaluate the clinical efficacy of acupuncture for cardiac neurosis.Methods:We searched China National Knowledge Infrastructure(CNKI),Chinese Academic Journals Database(CSPD),Chinese Sci-tech Journals Database(CCD),Chinese Biomedical Literature Database(CBM),Pubmed.According to the inclusion and exclusion criteria,we included acupuncture alone and Western medicine comparison,acupuncture combined with conventional Western medicine and we compared Western medicine treatment of the heart neurosis in Randomized Controlled Trials(RCT).The retrieval periods were all from the establishment of the database to January 25,2019.Data were extracted and the quality of the included trials was evaluated using the evaluation criteria recommended by the Cochrane collaboration,and meta-analysis was performed by Rev Man version 5.3.Results:A total of 15 RCTS were included,involving 1 344 patients.The meta-analysis results indicated that acupuncture combined with/without WM could make a better efficacy(RR=1.28,95% CI(1.21,1.35),P<0.01).The total effective rate of acupuncture treatment alone was also better than that of the control group(RR=1.25,95%CI 1.17,1.34,P<0.01).Acupuncture can effectively improved HAMA score(WMD=-4.10,95%CI is-4.58,-3.61,P<0.000 1) and HAMD score(WMD=-4.62,95%CI is-5.30,-3.93,P<0.000 01).Conclusion:Acupuncture is superior to conventional Western medicine in the treatment of cardiac neurosis.However,due to the limited number of included studies and low quality,the above conclusions need to be verified by more high-quality RCTs.