国内针刺治疗耳鸣疗效的系统评价

目的系统评价国内针刺治疗耳鸣的有效性和安全性。方法计算机检索CBM、CNKI、VIP和Wanfang Database,并手工检索参考文献,收集国内针灸治疗耳鸣的随机对照试验,由2名评价者独立提取资料并交叉核对并进行方法学质量评估。统计学分析采用RevMan 5.0.2软件,用漏斗图分析发表性偏倚。结果共纳入7个随机对照试验,包括655例患者。Meta分析结果显示,有效率:常规针刺优于药物(RR=1.99,95%CI(1.38,2.86));温通针刺优于常规针刺(RR=0.83,95%CI(0.68,1.00));电针针刺优于常规针刺(RR=0.76,95%CI(0.59,0.99));体针针刺与腹针无明显差异(RR=0.97,95%CI(0.86,1.10));常规针刺+药物刺穴优于药物(RR=1.26,95%CI(0.95,1.67));常规针刺与电针针刺+药物刺穴无明显差异(RR=1.25,95%CI(0.97,1.60))。无严重不良反应,漏斗图图形不对称,考虑存在发表性偏倚。结论针刺治疗耳鸣有较好的效果,不良反应少,但尚需更多高质量的随机对照试验来进一步证实其疗效。

Systems evaluation on acupuncture treatment for tinnitus in China

Objective It is to evaluate the efficacy and safety of acupuncture treatment for tinnitus in China.Methods Randomized controlled trials(RCTs) involving acupuncture treatment for tinnitus were identified from CBM,VIP,Wanfang Database and CNKI.Relevant journals from references were hand searched.Data were extracted and evaluated by two reviewers independently with a specially designed extraction form.Cochrane Collaboration’s RevMan 5.0.2 software was used for data analysis.Funnel plot was used for possible existence of publication bias.Results A total of 7 RCTs involving 655 patients were included.Meta-analysis showed that the total effective rate: Conventional acupuncture was better than drugs(RR=1.99,95%CI: 1.38 to 2.86);Wentong acupuncture was better than conventional acupuncture(RR=0.83,95%CI: 0.68 to 1.00);Electroacupuncture was better than conventional acupuncture(RR=0.76,95%CI: 0.59 to 0.99);Body acupuncture was as better as abdominal acupuncture(RR=0.97,95%CI: 0.86 to 1.10);Conventional acupuncture plus drugs thorn acupuncture point was better than drugs(RR=1.26,95%CI: 0.95 to 1.67);There was no obvious difference between conventional acupuncture and electroacupuncture plus drugs thorn acupuncture point(RR=1.25,95%CI: 0.97 to 1.60).There were no serious side effects in both groups,and Funnel plot is asymmetrical,which showed the possible existence of publication bias.Conclusion Acupuncture treatment for tinnitus is effective wi adverse reactions.Further large-scale trials are required to define the role of acupuncture in the treatment for tinnitus.th few