海南医科大学学报2025，Vol.31Issue(6)：443-456,14.DOI:10.13210/j.cnki.jhmu.20241203.002
针刺治疗支气管哮喘急性发作期临床疗效的meta分析
Meta-analysis on the clinical efficacy of acupuncture in treating acute exacerbations of bronchial asthma
摘要
Abstract
Objective:To comprehensively evaluate the clinical efficacy of acupuncture on acute exacerbations of bronchial asthma through a meta-analysis.Methods:RCTs of acupuncture for the treatment of acute exacerbations of bronchial asthma in eight databases(PubMed,Embase,Wos,Cochrane Library,Sinomed,Wipu,CNKI,and Wanfang)were searched by comput-er from the time of construction to October 1,2024.Two reviewers separately appraised the risk of bias and extracted the data.Da-ta were combined and analyzed using RevMan 5.4.Dichotomous outcomes were reported as RRs,and continuous outcomes were reported as SMDs with 95%CIs.The bias risk was evaluated via the application of the Cochrane tool,while the evidence was graded using the GRADE approach.Results:A total of 19 randomized controlled trials involving 2 137 patients were included.The results of the meta-analysis showed that the effective rate after acupuncture treatment(RR=2.01,95%CI 1.32 to 3.06,n=90,I2=0%,P=0.001,low quality)was superior to that of the sham acupuncture,and the total score of traditional Chinese med-icine symptoms and signs after acupuncture treatment(MD-5.99,95%CI-9.32 to-2.66,n=90,I2=93%,low quality)was lower than that of the sham acupuncture.The results of the meta-analysis showed that the level of IFN-γ after acupuncture treatment(SMD 0.27,95%CI 0.01 to 0.53,n=249,I2=3%,low quality)、FVC(SMD 0.54,95%CI 0.15,0.94,n=233,I2=52%,P=0.006,very low quality)was superior to that of drug treatment,and the total score of traditional Chinese medicine symp-toms and signs after treatment(MD-1.04,95%CI-1.76 to-0.32,n=606,I2=76%,low quality)was lower than that of drug treatment.However,acupuncture had little to no difference compared to drug treatment in terms of the effective rate after treatment(RR 1.11,95%CI 0.98 to 1.26,n=1 006,I2=94%,very low quality),FEV1(SMD 0.10,95%CI-0.29 to 0.49,n=1 329,I2=90%,very low quality),FEV1/FVC(MD 1.40,95%CI-2.45 to 5.25,n=840,I2=71%,very low quality),PEF(SMD 0.13,95%CI-0.23 to 0.48,n=1239,I2=87%,very low quality),and IL-4(SMD-0.43,95%CI-1.04 to 0.18,n=249,I2=82%,very low quality).Acupuncture combined with control could improve the effective rate of treatment(RR 1.22,95%CI 1.13 to 1.32,n=418,I2=0%,moderate quality)、IFN-γ(MD 4.96,95%CI 3.23,6.68,n=234,I2=43%,P<0.00 001,low quality)and post-treatment lung function,including FVC(SMD 0.57,95%CI 0.31 to 0.83,n=234,I2=0%,low quality),FEV1(SMD 1.03,95%CI 0.31 to 1.76,n=464,I2=92%,low quality)and PEF(SMD 1.27,95%CI 0.23 to 2.31,n=288,I2=94%,very low quality).However,there was little to no difference in post-treatment FEV1/FVC(MD 11.54,95%CI-1.03 to 24.11,n=230,I2=97%,very low quality)and post-treatment IL-4 levels(MD-8.78,95%CI-18.31 to 0.76,n=234,I2=90%,very low quality)when compared to the control group.Conclusion:Evidence indi-cates that acupuncture might demonstrate greater efficacy than sham acupuncture in addressing acute asthma exacerbations.The combination of acupuncture therapy has been shown to be more effective in enhancing treatment efficacy,improving pulmonary function,and promoting the expression of IFN-γ compared to medication alone.Nevertheless,the strength of evidence among studies is low,and new high-quality research is needed to provide more definitive evidence.关键词
针刺/支气管哮喘/meta分析/随机对照试验Key words
Acupuncture/Bronchial asthma/Meta-analysis/Randomized controlled trials分类
中医学引用本文复制引用
刘祁祁,刘俊麟,杨洋,曹文心,李竹英..针刺治疗支气管哮喘急性发作期临床疗效的meta分析[J].海南医科大学学报,2025,31(6):443-456,14.基金项目
This study was supported by National Natural Science Foundation of China(82274420) （82274420）
Construction Project of the Second Batch of Provincial Famous Traditional Chinese Medicine Expert Inheritance Studio in Heilongjiang Province[Heizhonghuayao Kejiaohan(2021)No.24] （2021）
Funding Project for Reserve Leaders of Heilongjiang Provincial Leading Talent Team[Black Social Letter(2021)No.296] 国家自然科学基金项目(82274420) （2021）
黑龙江省第二批省级名中医专家传承工作室建设项目[黑中医药科教函(2021)24号] （2021）
黑龙江省级领军人才梯队后备带头人资助项目[黑人社函(2021)296号] （2021）
