针刺治疗纤维肌痛综合征疗效的Meta分析

Meta-analysis of acupuncture for fibromyalgia syndrome

摘要:

系统评价针灸治疗纤维肌痛综合征的有效性与安全性。方法：计算机检索中国期刊全文数据库（CNKI）、万方学术期刊全文数据库（WangFang Data）、维普中文科技期刊数据库（VIP）、中国生物医学文献数据库（SinoMed）、PubMed、EMbase、The Cochrane Library，搜集针灸治疗纤维肌痛综合征的临床随机对照试验，检索时限均从建库至2021年12月30日。由两名研究者独立筛选文献、提取资料和评价纳入文献的偏倚风险，采用Revman5.3 软件对结局指标进行Meta分析。结果：共纳入14篇文献，776例患者。Meta分析显示：与西药组相比，针灸组纤维肌痛患者有效率 (RR = 1.25, 95% CI [1.14,1.37], P < 0.00001)、治愈率 (RR = 3.39, 95% CI [2.17, 5.30], P < 0.00001)均优于西药组；改善FIQ评分 (MD = -12.6, 95% CI [-20.56,-3.57], P = 0.005)、VAS评分 (MD = -1.66, 95% CI [-1.92,-1.39], P < 0.00001)、压痛点数 (MD = -2.74, 95% CI [-3.62,-1.87], P < 0.00001)，6月随访期总有效率(RR = 1.50, 95% CI [1.14,1.97], P = 0.004)的程度均优于西药组，安全性高。但在改善Athens睡眠障碍自评量表两组差异无统计学意义（P＞0.05）。结论：针灸治疗纤维肌痛具有一定的疗效优势，且安全性高。

Abstract:

To systematically evaluate the efficacy and safety of acupuncture and moxibustion in the treatment of fibromyalgia syndrome. Methods: CNKI, WangFang Data, VIP, SinoMed, PubMed, EMbase, The Cochrane Library were searched by computer to collect the clinical randomized controlled trials of acupuncture and moxibustion for fibromyalgia syndrome. Two researchers independently screened the literature, extracted the data and evaluated the bias risk of the included literature. Revman 5.3 software was used for meta analysis of the outcome indicators. Results: Totally 14 articles were included, 776 patients. Meta analysis showed that the effective rate (RR=1.25, 95% CI [1.14,1.37], P<0.00001) and cure rate (RR=3.39, 95% CI [2.17, 5.30], P<0.00001) of fibromyalgia patients in the acupuncture group were better than those in the western medicine group compared with those in the western medicine group; The FIQ score (MD=-12.6, 95% CI [-20.56, -3.57], P=0.005), VAS score (MD=-1.66, 95% CI [-1.92, -1.39], P<0.00001), tenderness points (MD=-2.74, 95% CI [-3.62, -1.87], P<0.00001), and the total effective rate (RR=1.50, 95% CI [1.14,1.97], P=0.004) in the 6-month follow-up period were better than those in the western medicine group, with high safety. However, there was no significant difference between the two groups in improving the Athens Sleep Disorder Self Rating Scale (P>0.05). Conclusion: Acupuncture and moxibustion treatment of fibromyalgia has certain therapeutic advantages and high safety.