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Received:June 29, 2021 Published Online:February 20, 2022
Received:June 29, 2021 Published Online:February 20, 2022
中文摘要: 目的 系统评价针灸疗法对痛风性关节炎(GA)的预后及安全性。方法 计算机检索中国知网、万方、维普、PubMed、Embase、Cochrane Library数据库,整理并纳入有关针灸治疗GA的临床对照试验,文献检索时间为建库至2021年6月。使用Cochrane协作网偏倚风险评估工具评价纳入文献的方法学质量。采用RevMan 5.3软件和R软件进行Meta分析和多因素Cox回归分析,并依据Cox回归分析结果进行亚组分析。结果 共纳入文献23篇,总计2 458例GA患者。Meta分析结果显示,相较于仅接受药物治疗的患者,接受针灸疗法治疗的患者在血尿酸水平[WMD=-53.98,95%CI(-85.01,-22.95),P<0.01]、红细胞沉降率[WMD=-6.01,95%CI(-10.35,-1.67),P<0.01]和总不良反应发生率[OR=0.12,95%CI(0.08,0.18),P<0.01]方面均有显著改善;同时,针灸治疗组患者的复发率显著低于非针灸治疗组[OR=0.20,95%CI(0.14,0.28),P<0.01]。Cox多因素回归分析结果进一步验证,因接受针灸治疗而降低的复发率不受其他潜在因素影响,且是否使用针灸治疗与复发率的关联性最显著。结论 针灸治疗能显著改善GA患者血尿酸水平,减轻炎症反应,降低不良反应发生率和复发率。
Abstract:Objective To systematically evaluate the prognosis and safety of acupuncture therapy in the clinical treatment of gouty arthritis (GA).Methods The controlled clinical trials of acupuncture therapy for GA were retrieved from the databases including CNKI, Wanfang Data, VIP, PubMed, Embase and Cochrane Library. The literature search time was from the establishment of the database to June 2021. The quality of the included studies was evaluated by Cochrane collaboration bias risk assessment tool. The process of meta-analysis and Cox multivariate regression analysis were respectively performed by RevMan 5.3 software and R software, and subgroup analysis were performed based on the result of Cox multivariate regression analysis. Results A total of 23 studies involving 2 458 patients were included in the study. The results showed that compared with patients who received only drug treatment, patients who received acupuncture therapy had significantly improved blood uric acid level [WMD=-53.98, 95%CI (-85.01, -22.95), P<0.01], erythrocyte sedimentation rate [WMD=-6.01, 95%CI (-10.35, -1.67), P<0.01] and the incidence of total adverse reactions [OR=0.12, 95%CI (0.08, 0.18), P<0.01]. The recurrence rate of patients in the acupuncture treatment group was significantly lower than that of the non-acupuncture treatment group [OR=0.20, 95%CI (0.14, 0.28), P<0.01]. Cox multivariate regression analysis further confirmed that the recurrence rate reduced by acupuncture treatment was not affected by other factors, and treatment with/without acupuncture therapy had the significant correlation with the recurrence rate (P<0.01). Conclusion Acupuncture treatment can significantly improve the blood uric acid level of GA patients, reduce inflammation, and reduce the incidence of adverse reactions and recurrence rates.
keywords: Acupuncture Gouty arthritis Prognosis Safety Meta analysis
文章编号: 中图分类号:R259 文献标志码:A
基金项目:澳门科技发展基金项目(0010/2019/A)
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