引用本文:袁晓艺,何胜兰,杜紫菲,吕 航,王 勇.穴位治疗对子宫内膜异位症疗效的网状Meta分析[J].中国临床新医学,2024,17(6):666-672.
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穴位治疗对子宫内膜异位症疗效的网状Meta分析
袁晓艺1,何胜兰2,杜紫菲3,吕 航4,王 勇3
1.广州中医药大学附属广州中医医院,广东 510080;2.广州中医药大学针灸康复临床医学院,广东 510080;3.广州医科大学附属中医医院妇科,广东 510080;4.广州医科大学附属中医医院针灸科,广东 510080
摘要:
[摘要] 目的 系统评估穴位治疗对子宫内膜异位症(EMT)的疗效。方法 在PubMed、the Cochrane Library、Embase、中国知网等数据库检索以穴位治疗为代表的不同中医外治法治疗EMT的相关文献,检索时间为各数据库建库至2023年6月1日。最终纳入66篇文献,均为随机对照试验(RCT)研究,包括6种治疗组合:单纯中药治疗,单纯西药治疗,单纯穴位治疗,中药联合穴位治疗,西药联合穴位治疗,西药、中药联合穴位治疗。采用网状Meta分析评估治疗方法对主要结局指标癌抗原125(CA125)、雌二醇(E2)、促卵泡激素(FSH)、黄体生成素(LH)、前列腺素F2α(PGF2α)、视觉模拟量表(VAS)评分的影响。结果 一致性模型分析结果显示,在CA125水平的改善方面,西药联合穴位治疗的效果显著优于单纯中药治疗、单纯西药治疗(P<0.05),其余治疗组比较差异无统计学意义(P>0.05)。在LH水平的改善方面,西药、中药联合穴位治疗的效果显著优于单纯西药治疗(P<0.05),其余治疗组比较差异无统计学意义(P>0.05)。在PGF2α水平的改善方面,西药联合穴位治疗的效果显著优于单纯中药治疗、单纯西药治疗、单纯穴位治疗、中药联合穴位治疗以及西药、中药联合穴位治疗(P<0.05),中药联合穴位治疗及西药、中药联合穴位治疗的效果显著优于单纯西药治疗(P<0.05),其余治疗组比较差异无统计学意义(P>0.05)。在E2、FSH水平及VAS评分的改善方面,各治疗组效果差异无统计学意义(P>0.05)。结论 穴位治疗作为辅助疗法,可有效促进EMT关键指标的改善。
关键词:  子宫内膜异位症  穴位治疗  随机对照试验  网状Meta分析
DOI:10.3969/j.issn.1674-3806.2024.06.14
分类号:R 271.19
基金项目:国家自然科学基金项目(编号:82004450);广东省中医药管理局科研项目(编号:20221317,20241222)
A network Meta-analysis on the efficacy of acupoint therapy for endometriosis
YUAN Xiaoyi1, HE Shenglan2, DU Zifei3, LYU Hang4, WANG Yong3
1.The Affiliated TCM Hospital of Guangzhou University of Chinese Medicine, Guangdong 510080, China; 2.Guangzhou University of Chinese Medicine Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangdong 510080, China; 3.Department of Gynecology, the Affiliated TCM Hospital of Guangzhou Medical University, Guangdong 510080, China; 4.Department of Acupuncture and Moxibustion, the Affiliated TCM Hospital of Guangzhou Medical University, Guangdong 510080, China
Abstract:
[Abstract] Objective To systematically evaluate the efficacy of acupoint therapy for endometriosis(EMT). Methods The literature related to the treatment of EMT with different Traditional Chinese Medicine(TCM) external therapeutic methods represented by acupoint therapy was searched in PubMed, the Cochrane Library, Embase, and Chinese National Knowledge Infrastructure(CNKI) databases. The searched papers were collected in each database from its establishment time to June 1, 2023. Finally, 66 papers were included, all of which were randomized controlled trial(RCT) studies, including 6 therapeutic combinations: simple TCM therapy, simple Western medicine therapy, simple acupoint therapy, TCM combined with acupoint therapy, Western medicine combined with acupoint therapy, Western medicine and TCM combined with acupoint therapy. Network Meta-analysis was used to evaluate the effects of the therapeutic methods on major outcome indicators including cancer antigen 125(CA125), estradiol(E2), follicle-stimulating hormone(FSH), luteinizing hormone(LH), prostaglandin F2α(PGF2α) and Visual Analogue Scale(VAS) score. Results The results of the consistency model analysis showed that in terms of the improvement of CA125 level, the effect of Western medicine combined with acupoint therapy was significantly better than that of simple TCM therapy and simple Western medicine therapy(P<0.05), and there was no statistically significant difference in the improvement of CA125 level among the other therapeutic groups(P>0.05). In terms of the improvement of LH level, the effect of Western medicine and TCM combined with acupoint therapy was significantly better than that of simple Western medicine therapy(P<0.05), and there was no statistically significant difference in the improvement of LH level among the other therapeutic groups(P>0.05). In terms of the improvement of PGF2α level, the effect of Western medicine combined with acupoint therapy was significantly better than that of simple TCM therapy, simple Western medicine therapy, simple acupoint therapy, TCM combined with acupoint therapy, and Western medicine and TCM combined with acupoint therapy(P>0.05), and the effect of TCM combined with acupoint therapy and Western medicine and TCM combined with acupoint therapy was significantly better than that of simple Western medicine therapy(P<0.05). There was no statistically significant difference in the improvement of PGF2α level among the other therapeutic groups(P>0.05). There were no statistically significant differences in the improvements of E2 and FSH levels, and VAS scores among the other therapeutic groups(P>0.05). Conclusion Acupoint therapy, as an adjuvant therapy, can effectively promote the improvement of key indicators of EMT.
Key words:  Endometriosis(EMT)  Acupoint therapy  Randomized controlled trial(RCT)  Network Meta-analysis