针灸疗法治疗慢性湿疹的系统评价再评价＊

目的 评价针灸疗法治疗慢性湿疹系统评价（Systematic review, SR）的方法学质量、报告质量与证据质量。方法 通过计算机检索EMbase、PubMed、Medline、Cochrane Library、CBM、CNKI、Wanfang和VIP等数据库建库至2021年4月1日的系统评价/meta分析,使用NoteExpress 3.2.0进行文献管理,从文献发表年份、临床研究设计类型、AMSTAR 2、PRISMA、异质性、发表偏倚风险等方面进行雷达图多元评价;GRADE系统进行证据质量评级。结果 最终纳入6篇SR/Meta分析,雷达图多元评价质量秩平均得分为4.31,主要问题为未进行项目注册、未提供排除文献清单,未分析纳入研究的偏倚风险,未报告纳入研究的资金来源、未对纳入文献的敏感性或者其他方面进行分析等。GRADE证据质量评分均为低证据与极低证据等级,主要原因包括纳入原始研究质量不高、结局指标存在较大异质性、纳入文献数量不足等。结论 受纳入原始研究和SR/Meta分析的质量限制,现有针灸疗法治疗慢性湿疹的结论尚需开展更多高质量的研究予以验证,也为临床医生提供更高级别证据。

Overview of Systematic Review of Acupuncture in the Treatment of Chronic Eczema

Objective To evaluate the methodological quality, report quality and evidence quality of systematic review of acupuncture in the treatment of chronic eczema.Methods EMbase, PubMed, Medline, Cochrane Library, CBM, CNKI, Wanfang, and VIP were searched to collect systematic review/meta-analysis of acupuncture for chronic eczema from inception to April 1, 2021. NoteExpress 3.2.0 was used for screening and data extraction. Then the radar chart was used to conduct multiple evaluations from six perspectives: publication year, study type, AMSTAR 2 score, PRISMA score, heterogeneity, and publication bias, and GRADE System was used to rank the quality of evidence.Results A total of six systematic reviews/Meta-analyses were included, and the average score of the radar chart multivariate evaluation quality rank was 4.31. The main problems were that the project was not registered; the excluded literature list was not provided; the risk of bias of the included studies was not analyzed; the funding source of the included studies was not reported; and the sensitivity of the included literatures or other aspects were not analyzed. The GRADE scores showed that all the included articles were graded as ''low'' or ''very low'' quality. The main reasons included the low quality of the original research, the large heterogeneity of the outcome indicators, and the insufficient number of included literature, etc.Conclusion The efficacy of acupuncture in the treatment of chronic eczema is clear, but as the quality limitations of the included studies, it is expected to be further verified by high quality researches, and provide a higher level of evidence for clinical research.