刺络放血疗法治疗急性扁桃体炎有效性的Meta分析(1)
【摘要】 目的 針对刺络放血疗法治疗急性扁桃体炎的效果进行系统评价。方法 通过计算机检索 PubMed、EMbase、The Cochrane Library及中国知网、万方、中国生物医学文献数据库，搜集使用刺络放血疗法干预急性扁桃体炎的相关随机对照试验(RCT)，检索时限均从建库至2019年11月6日。由2名研究者独立筛选文献、提取资料、评价纳入研究的偏倚风险，并交叉核对，使用 RevMan 5.3 软件进行统计分析。结果 共纳入22个RCT，包括7419例患者。Meta 分析结果显示：刺络放血组及刺络放血联合中药、西药组的总有效率高于单纯西药组[OR=4.05，95%CI(2.57，6.39)，P<0.00001];刺络放血组及刺络放血联合西药组较单纯西药组的退热时间明显缩短[SMD =-1.07，95%CI(-1.50，-0.63)，P<0.0001];刺络放血组及刺络放血联合西药组较单纯西药组咽痛及脓性分泌物消失时间明显缩短;刺络放血能明显降低血CRP[SMD=-1.43，95%CI(-1.80， -1.07)，P<0.0001]及中性粒细胞百分比[SMD=-0.97， 95%CI(-1.73， -0.21)，P=0.01];但刺络放血不能降低血白细胞计数[SMD=-0.381，95%CI(-0.92，0.29)，P=0.31]。结论 刺络放血疗法单独应用、作为中药及西药的辅助治疗方法在总有效率、症状体征的改善、退热时间等方面均优于单纯的西药治疗，但血白细胞计数的Meta分析显示无统计学意义，暂不能认为刺络放血疗法能有效地改善血液的炎症指标。该结论有待更多高质量、大样本研究进行验证。
【关键词】 刺络放血疗法;急性扁桃体炎;Meta 分析
中图分类号：R242 文献标志码：A DOI：10.3969/j.issn.1003-1383.2020.10.003
【Abstract】 Objective To systematically review the efficacy of acupuncture Bloodletting on treatment of acute tonsillitis. Methods PubMed， EMbase，The Cochrane Library， CNKI， WanFang Data and China Biology Medicine disc (CBMdisc) were electronically searched to collect randomized controlled trials (RCTs) on acupuncture Bloodletting treatment of acute tonsillitis from the establishment of the databases to November 6， 2019. Two reviewers independently screened literature， extracted data and assessed risk of bias of included studies， cross-check was carried out， and meta-analysis was performed by using RevMan 5.3 software. Results A total of 22 RCT were included， including 7419 patients. The results of Meta analysis showed that the total effective rate of the acupuncture Bloodletting group and the acupuncture Bloodletting combined with traditional Chinese medicine and Western medicine group was higher than that of the simple Western medicine group [OR = 4.05，95%CI (2.57，6.39)， P < 0.00001]. The antipyretic time of the acupuncture Bloodletting group and the acupuncture Bloodletting combined with Western medicine group was significantly shorter than that of the simple Western medicine group [SMD = -1.07， 95%CI(-1.50， -0.63)，P < 0.0001]. The disappearance time of sore throat and purulent secretion in the acupuncture Bloodletting group and acupuncture Bloodletting combined with Western medicine group was significantly shorter than that in the Western medicine group. In addition， acupuncture Bloodletting could significantly reduce CRP [SMD = -1.43，95%CI (-1.80， -1.07)， P < 0.0001] and neutrophil percentage [SMD = -0.97， 95%CI (-1.73， -0.21)， P = 0.01]， but it could not reduce blood white blood cell counts [SMD = -0.381， 95%CI (-0.92， 0.29)， P = 0.31]. Conclusion Whether single application or as an assistant therapy of traditional Chinese medicine and Western medicine， acupuncture Bloodletting therapy has better performance than Western medicine alone in the total effective rate， the improvement of symptoms and signs， and the time of antipyretic， etc. However， the Meta-analysis of leukocyte count shows no statistical significance， so it can not be considered that acupuncture Bloodletting therapy can effectively reduce the inflammatory index of blood. This conclusion needs to be verified by more high-quality， large sample studies., http://www.100md.com(邓小春 蒋运兰 邱娟 杨晓莲 李栋霜 李庆)
【关键词】 刺络放血疗法;急性扁桃体炎;Meta 分析
中图分类号：R242 文献标志码：A DOI：10.3969/j.issn.1003-1383.2020.10.003
【Abstract】 Objective To systematically review the efficacy of acupuncture Bloodletting on treatment of acute tonsillitis. Methods PubMed， EMbase，The Cochrane Library， CNKI， WanFang Data and China Biology Medicine disc (CBMdisc) were electronically searched to collect randomized controlled trials (RCTs) on acupuncture Bloodletting treatment of acute tonsillitis from the establishment of the databases to November 6， 2019. Two reviewers independently screened literature， extracted data and assessed risk of bias of included studies， cross-check was carried out， and meta-analysis was performed by using RevMan 5.3 software. Results A total of 22 RCT were included， including 7419 patients. The results of Meta analysis showed that the total effective rate of the acupuncture Bloodletting group and the acupuncture Bloodletting combined with traditional Chinese medicine and Western medicine group was higher than that of the simple Western medicine group [OR = 4.05，95%CI (2.57，6.39)， P < 0.00001]. The antipyretic time of the acupuncture Bloodletting group and the acupuncture Bloodletting combined with Western medicine group was significantly shorter than that of the simple Western medicine group [SMD = -1.07， 95%CI(-1.50， -0.63)，P < 0.0001]. The disappearance time of sore throat and purulent secretion in the acupuncture Bloodletting group and acupuncture Bloodletting combined with Western medicine group was significantly shorter than that in the Western medicine group. In addition， acupuncture Bloodletting could significantly reduce CRP [SMD = -1.43，95%CI (-1.80， -1.07)， P < 0.0001] and neutrophil percentage [SMD = -0.97， 95%CI (-1.73， -0.21)， P = 0.01]， but it could not reduce blood white blood cell counts [SMD = -0.381， 95%CI (-0.92， 0.29)， P = 0.31]. Conclusion Whether single application or as an assistant therapy of traditional Chinese medicine and Western medicine， acupuncture Bloodletting therapy has better performance than Western medicine alone in the total effective rate， the improvement of symptoms and signs， and the time of antipyretic， etc. However， the Meta-analysis of leukocyte count shows no statistical significance， so it can not be considered that acupuncture Bloodletting therapy can effectively reduce the inflammatory index of blood. This conclusion needs to be verified by more high-quality， large sample studies., http://www.100md.com(邓小春 蒋运兰 邱娟 杨晓莲 李栋霜 李庆)