文献类型：期刊文献

中文题名：针灸综合疗法较激素治疗急性期周围性面神经麻痹结局指标的Meta分析

英文题名：The Comprehensive Acupuncture and Moxibustion Therapy Compared with Hormonal Treatment for Acute Phase Peripheral Facial Nerve Palsy s Outcome Indicators:A Meta-analysis

作者：马涵[1];庞永强[1];张茜[1];徐彦龙[2]

第一作者：马涵

机构：[1]甘肃中医药大学,甘肃兰州730000;[2]甘肃省中医院,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2024

卷号：33

期号：9

起止页码：100

中文期刊名：中国民族民间医药

外文期刊名：Chinese Journal of Ethnomedicine and Ethnopharmacy

语种：中文

中文关键词：急性期周围性面神经麻痹;针灸综合疗法;激素;系统评价;Meta分析

外文关键词：Acute Phase Peripheral Facial Nerve Palsy;The Comprehensive Acupuncture and Moxibustion Therapy;Hormonal Therapy;Systematicevaluation;Meta-analysis

摘要：目的:系统评价针灸综合疗法较激素治疗急性期周围性面神经麻痹的疗效差异。方法:通过计算机检索中国知网数据库(CNKI)、中国生物医学文献数据库(SinoMed)、维普中文科技期刊数据库(VIP)、万方数据知识服务平台(WanFang Data)、PubMed、Cochrane图书馆(Cochrane Library)、Web Of Science、Embase数据库。检索语言为中文和英文。检索时限均从建库至2023年1月21日,由2位研究者独立对纳入文献进行资料提取和质量评价后,采用RevMan 5.4统计软件进行Meta分析。结果:共纳入8篇文献,病例数896例,Meta分析结果提示:①针灸综合疗法治疗急性期PFP的愈显率高于激素疗法(OR=2.36,95%CI[1.43,3.90],Z=3.35,P=0.0008);②针灸综合疗法对于急性PFP患者H-B面神经功能的改善优于激素疗法(WMD=-0.27,95%CI[-0.49,-0.06],Z=2.50,P=0.01);③针灸综合疗法治疗急性期PFP的治愈时间短于激素疗法(WMD=-0.63,95%CI[-0.92,-0.34],Z=4.22,P<0.0001);④纳入文献中仅有2篇报道了并发症发生率的观察指标,且两组数据比较无统计学意义,故无法判断哪种疗法能降低并发症的发生率;⑤在病情发展方面,针灸综合疗法介入后的急性期PFP进展过程要慢于当激素介入时(OR=0.34,95%CI[0.17,0.67],Z=3.08,P=0.002)。结论:基于本次Meta分析,针灸综合疗法治疗急性期PFP安全有效,可以提高愈显率,改善面神经功能,缩短痊愈所需时间,而其在上述各指标方面与激素的比较中占有优势,故当以针灸综合疗法干预急性期PFP时,可以考虑不执着于选择激素,但此次系统评价仍较为局限,未来还需更多高质量、大样本的临床对照试验为针灸与激素干预急性期PFP时的差异性比较提供更加客观明确的循证依据。
Objective To systematically evaluate the difference in efficacy of the comprehensive acupuncture and moxibustion therapy compared with hormonal treatment for acute phase peripheral facial nerve palsy.Methods Through computer search of CNKI,WanFang Data,VIP,SinoMed,PubMed,Cochrane Library,Web Of Science,Embase databases.The search language is Chinese and English.The search time frame was all from the creation of the database to January 21,2023,and Meta-analysis was performed using RevMan 5.4 statistical software after data extraction and quality evaluation of the included literature by two researchers independently.Results Atotal of 8 trials were included,involving 896 patients.The Meta-analysis results showed that:①The healing rate of comprehensive acupuncture and moxibustion therapy for acute peripheral facial nerve palsy is higher than that of hormonal therapy(OR=2.36,95%CI[1.43,3.90],Z=3.35,P=0.0008);②The comprehensive acupuncture and moxibustion therapy improves H-B facial nerve function better than hormone therapy in acute PFP(WMD=-0.27,95%CI:-0.49,-0.06,Z=2.50,P=0.01);③The comprehensive acupuncture and moxibustion therapy for acute peripheral facial nerve palsy requires less time to heal than hormonal therapy(WMD=-0.63,95%CI:-0.92,-0.34,Z=4.22,P<0.0001);④Only 2 of the included literature reported on the observation of complication rates,and the data from both groups were not statistically significant,so it was not possible to determine which therapy reduced the incidence of complications;⑤In terms of disease development,the progression of PFP in the acute stage after acupuncture and moxibustion therapy was slower than that when hormone was involved(OR=0.34,95%CI:0.1,0.67,Z=3.08,P=0.002).Conclusion Based on the current evidence,In the acute phase of peripheral facial paralysis,the comprehensive acupuncture and moxibustion therapy is safe and effective,which can improve the recovery rate,improve facial nerve function and shorten the time required for recovery.Therefore,hormonal therapy can be gradually replaced in clinical practice.Compared with hormones in the above indexes,acupuncture and moxibustion has an advantage.Therefore,when the combination therapy of acupuncture and moxibustion is used to intervene in the acute stage of PFP,it can be considered not to insist on the selection of hormones.However,this systematic evaluation is still limited.In the future,more high-quality and large-sample controlled clinical trials are needed to provide more objective and clear evidence-based basis for the difference comparison between acupuncture and hormone intervention in acute stage PFP.