■为了对原发性痛经最有效的针灸疗法进行比较和排名,并为该病的临床治疗提供循证医学支持。
■对中国国家知识基础设施(CNKI)进行了全面搜索,万方数据库,中文期刊信息服务平台(VIP),中国生物医学文献服务系统(中国医学),PubMed,WebofScience,Embase,和Cochrane图书馆数据库从成立到2023年5月1日。使用Cochrane协作偏差风险工具评估偏差风险,采用Stata15.1软件和R4.3.1软件的GeMTC软件包进行网络Meta分析。
■包括70项研究,包括5772例原发性痛经患者,涉及临床常用的25种针灸技术。纳入文献质量较低,他们中的大多数没有提到临床试验中心的注册信息,具体的样本量估算方法尚不清楚。一些文献没有解释具体的随机方法,分布隐蔽性和盲目性,因此存在一定的发表偏倚和小样本效应。结果表明,提高临床有效率,前三名是盐隔灸,按摩疗法+穴位敷贴,针灸+热敏灸。在降低视觉模拟量表(VAS)方面,前三名的治疗方法是按摩疗法+穴位修补,针刺+穴位贴敷和温针灸。在缓解考克斯月经症状量表(CMSS)方面,前三名是针灸+穴位贴敷,穴位修补和穴位埋线。在缓解中医症状评分方面,前三个治疗方法是穴位贴敷+热敏灸,穴位敷贴和艾灸。
■不同的针灸疗法在提高临床有效率方面比口服镇痛药更具优势,降低VAS评分,降低CMSS得分,减轻中医症状积分。其中,按摩疗法+穴位敷贴,针刺+穴位敷贴和穴位敷贴可能是治疗原发性痛经的最佳方案。然而,更多的大样本,需要多中心和高质量的随机对照试验来证明.
UNASSIGNED: In order to compare and rank the most effective acupuncture therapy for primary dysmenorrhea and provide evidence-based medical support for clinical treatment of this disease.
UNASSIGNED: A comprehensive search was conducted on
China National Knowledge Infrastructure (CNKI), Wanfang Database, Information Chinese Journal Service Platform (VIP),
China Biomedical Literature Service System (SinoMed), PubMed, Web of Science, Embase, and Cochrane Library databases from their inception to May 1, 2023. The Cochrane Collaboration Risk of Bias Tool was used to evaluate bias risk, and the GeMTC package of Stata 15.1 software and R 4.3.1 software was used to perform network Meta-analysis.
UNASSIGNED: 70 studies were included, including 5772 patients with primary dysmenorrhea, involving 25 kinds of acupuncture techniques commonly used in clinic. The quality of the included literature was low, most of them did not mention the registration information of clinical trial centers, and the specific sample size estimation method was unclear. Some literature did not explain the specific random method, distribution concealment and blindness, so there was a certain publication bias and small sample effect. Results showed that for improving the clinical effective rate, the top three treatments were salt-separated moxibustion, massotherapy + acupoint patching, acupuncture + heat-sensitive moxibustion. In terms of reducing the visual analogue scale(VAS), the top three treatments were massotherapy + acupoint patching, acupuncture + acupoint patching and warm acupuncture. In terms of alleviating cox menstrual symptom scale (CMSS), the top three treatments were acupuncture + acupoint patching, acupoint patching and point embedding. In relieving TCM symptom score, the top three treatments were acupoint patching + heat-sensitive moxibustion, acupoint patching and moxibustion.
UNASSIGNED: Different acupuncture therapies have more advantages than oral analgesics in improving the clinical effective rate, reducing VAS score, reducing CMSS score, and alleviating TCM symptom score. Among them, massage therapy + acupoint patching, acupuncture + acupoint patching and acupoint patching may be the best solutions for the treatment of primary dysmenorrhea. However, more large-sample, multi-center and high-quality randomized controlled trials are needed to demonstrate.