针刺及联合其它疗法治疗反流性食管炎的系统评价

易越<sup>1; 2; 3</sup>; 裴丽霞<sup>1; 3</sup>; 陈昊<sup>3; 4</sup>; 刘亚军<sup>1</sup>; 顾培青<sup>1</sup>; 陈璐<sup>1; 3</sup>; 孙建华<sup>1; 3</sup>

文章摘要

易越，裴丽霞，陈昊，刘亚军，顾培青，陈璐，孙建华.针刺及联合其它疗法治疗反流性食管炎的系统评价[J].南京中医药大学学报(社会科学版),2020,36(4):546-551.

针刺及联合其它疗法治疗反流性食管炎的系统评价

Systematic Evaluation of Acupuncture and Combined Therapies for Treating Reflux Esophagitis

DOI：

中文关键词: 关键词：针刺反流性食管炎系统评价

英文关键词: acupuncture reflux esophagitis systematic evaluation

基金项目:

作者	单位
易越^1，2，3，裴丽霞^1，3，陈昊^3，4，刘亚军¹，顾培青¹，陈璐^1，3，孙建华^1，3	1.南京中医药大学附属医院/江苏省中医院，江苏南京 210029；2.南京中医药大学第一临床医学院，江苏南京 210023；3.南京中医药大学针药结合教育部重点实验室，江苏南京 210023；4.南京中医药大学针灸推拿学院·养生康复学院，江苏南京 210023

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中文摘要:

目的系统评价针刺对反流性食管炎（RE）的疗效。方法检索建库至2019年5月CNKI、WANFANG、VIP、CBM、PubMed、Embase、Cochrane Library数据库中针刺治疗RE的临床随机对照研究，提取纳入文献的基本资料并评价其质量，用Rev Man5.3软件进行Meta分析。结果共纳入13个研究，共1 120名患者。在降低复发率方面，单独针刺或针药结合均优于西药[针刺：RR=0.21，95%CI(0.05，0.87)；针刺+六君疏肝方:RR=0.44，95%CI(0.27，0.71) ;针刺+半夏泻心汤加减:RR=0.29，95%CI(0.14，0.60);针刺+旋覆代赭汤合左金丸加减:RR=0.40，95%CI(0.26，0.62);针刺+自拟中药方+微波热疗:RR=0.24，95%CI(0.08，0.66)]。在内镜有效率方面，电针联合西药治疗RE优于单独西药治疗[RR=1.23，95%CI(1.06，1.41)]。在降低症状积分方面，针药结合治疗RE的疗效较西药治疗更优[针刺+中药:RR=-1.73，95%CI(-3.21，-0.25)，针刺+中药+西药:RR=-4.93，95%CI(-5.52，-4.34)]。针药结合治疗RE的不良反应少于单独西药治疗。结论针药结合治疗RE安全有效且复发率低，然而单纯针刺治疗RE的疗效目前尚不明确，针灸治疗RE的相关研究亟需统一疗效标准，提高研究质量，未来仍需要更多高质量随机对照试验来验证针灸治疗RE的效果。

英文摘要:

OBJECTIVE To systematically evaluate the efficacy of acupuncture in reflux esophagitis (RE). METHODS Based on retrieving the clinical randomized controlled studies on acupuncture treatment of RE in CNKI， WANFANG， VIP， CBM， PubMed， Embase and Cochrane Library databases up to May 2019， the related literature was extracted and evaluated with Meta-analysis on Rev Man5.3. RESULTS A total of 13 studies with 1 120 patients were included. In terms of reducing the recurrence rate， acupuncture alone or combination of acupuncture and medicine was superior to Western medicine [acupuncture alone: RR=0.21， 95%CI(0.05， 0.87); acupuncture + Liujun Shugan Decoction: RR=0.44， 95%CI(0.27， 0.71); acupuncture + Banxia Xiexin Decoction: RR=0.29， 95%CI(0.14， 0.60); acupuncture + Xuanfu Daizhe Decoction and Zuojin Pill: RR=0.40， 95%CI(0.26， 0.62); acupuncture + self-prescribed Chinese medicine + microwave hyperthermia: RR=0.24， 95%CI(0.08， 0.66)]. In terms of endoscopic efficiency， electroacupuncture combined with Western medicine was better than Western medicine alone[RR=1.23， 95%CI(1.06， 1.41)]. In terms of reducing the symptom scores， the combination of acupuncture and medicine was more effective than Western medicine [acupuncture + Chinese medicine: RR=-1.73， 95%CI(-3.21， -0.25)， acupuncture + Chinese medicine + Western medicine: RR=-4.93， 95%CI(-5.52， -4.34)]. The adverse reactions of acupuncture combined with medicine were less than those of Western medicine alone.CONCLUSION In the treatment of RE， acupuncture combined with medicinal could obtain higher efficacy and lower recurrence while the efficacy of acupuncture alone is still unclear. Thus， there is an urgent need to standardize the efficacy of acupuncture in the treatment of RE and improve the quality of research. More high-quality randomized controlled trials are still needed in the future to validate the effectiveness of acupuncture for RE.

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