针刺治疗神经性耳鸣的系统评价和Meta分析

Systematic review and Meta analysis of acupuncture for the treatment of neuropathic tinnitus

关键词:  针刺  神经性耳鸣  随机对照试验  系统评估  Meta分析

Key words:  acupuncture  neuropathic tinnitus  randomized controlled trials  systematic evaluation  Meta analysis

摘要:

[目的]对针刺相比于药物治疗神经性耳鸣的优效性进行系统评价和Meta分析。[方法]对相关数据库进行检索，收集近5年内针刺治疗神经性耳鸣的随机对照试验，根据纳入和排除标准，选择符合研究标准的文献，根据Cochrane系统评价手册5.0版推荐的方法进行文献质量分析，并采用RevMan5.3进行Meta分析，并采用漏斗图进行偏倚分析。[结果]以受试者数量为计数单位的7篇文献中，针刺组330例，对照组284例，合并效应量OR=3.26，95%CI（2.09，5.08），Z=5.23，P<0.000 01，提示针刺治疗神经性耳鸣总有效率优于常规药物治疗，差异有统计学意义。以患耳数量为计数单位的2篇文献中，针刺组280例，对照组280例，合并效应量OR=1.39，95%CI（0.93，2.08），Z=1.62，P=0.11，提示针刺治疗神经性耳鸣相比于常规药物治疗的差异不具有统计学意义，但这两篇文献的数据很可能存在重叠。[结论]对于神经性耳鸣的治疗，针刺的总有效率优于常规药物治疗，且具有统计学意义。但由于文献质量的限制，该结果尚有待进一步论证。

Abstract:

[Objective] To perform systematic reviews and Meta-analysis for the superiority of acupuncture compared to drug therapy for the treatment of neuropathic tinnitus.[Methods] To search the related databases to collect the randomized controlled trials of acupuncture treatment of neurological rhinitis, select the eligible literatures according to the inclusion and exclusion criteria, perform articles quality analysis with the method recommended by Cochrane Systematic Review Manual Version 5.0, and make Meta-analysis with RevMan5.3 and bias analysis with funnel plots.[Results] As for the 7 articles which used the number of subjects as the count units, there were respectively 330 and 284 subjects in the treatment and control group with a combined effect of RR=0.17, 95% CI (0.11, 0.25), Z=5.43, P<0.000 01, which suggested that total efficiency of acupuncture treatment was superior to that of conventional drug for the treatment of neuropathic tinnitus and the difference was statistically significant.As for the 2 articles which used the number of ill ears as the count units, there were respectively 280 and 280 subjects in the treatment and control group with a combined effect of RR=1.39,95%CI(0.93, 2.08), Z=1.62,P=0.11, which suggested that total efficiency of acupuncture treatment was superior to that of conventional drug for the treatment of neuropathic tinnitus but the difference was not statistically significant. According to the search, the data in these two articles were likely to overlap.[Conclusion] For the treatment of neuropathic tinnitus, total efficiency of acupuncture treatment was superior to that of conventional drug for the treatment of neuropathic tinnitus and the difference was statistically significant. However, this result remains to be further demonstrated due to the quality of the literature.