本文選題：針刺　切入點(diǎn)：經(jīng)前期緊張綜合征　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過META分析,對針刺治療經(jīng)前期緊張綜合征的臨床療效進(jìn)行評價,為后續(xù)針刺治療經(jīng)前期緊張綜合征臨床研究提供一定的理論基礎(chǔ)及臨床治療經(jīng)驗(yàn)。方法:以循證學(xué)為依據(jù),檢索近16年國內(nèi)外針刺治療經(jīng)前期緊張綜合征的RCT試驗(yàn),并對納入文獻(xiàn)進(jìn)行質(zhì)量評價,meta分析使用Revman5.1軟件進(jìn)行,以異質(zhì)性檢驗(yàn)結(jié)果為依據(jù)來進(jìn)行效應(yīng)模型的選擇,選擇相對危險度(risk ratio,RR)來表示結(jié)局效應(yīng)指標(biāo),均以95%可信區(qū)間(conf idence interval,CI)表示。結(jié)果:本研究共納入12個研究,共計865名患者,其中對照組為西藥的文章9篇,對照組為中藥的文章2篇,對照組既有中藥也有西藥的文章1篇(此文章分2次統(tǒng)計)。Meta分析結(jié)果顯示:1、對照組為西藥的10個研究(其中1個研究采用針刺VS中藥VS西藥分別對照)均采用有效率作為結(jié)局指標(biāo),Meta分析結(jié)果顯示,合并OR:4.23[2.78,6.44],總體效應(yīng)P0.00001(P0.05),針刺組與西藥對照組臨床總有效率差異有統(tǒng)計學(xué)意義,針刺療效優(yōu)于西藥。其中4個研究對頭痛指數(shù)進(jìn)行分析,Meta分析結(jié)果顯示,頭痛指數(shù)MD:-4.57[-7.14,-1.72],總體效應(yīng)P=0.0002(P0.05),針刺組療效優(yōu)于西藥組。其中2個研究對復(fù)發(fā)率進(jìn)行分析,Meta分析結(jié)果顯示,合并OR:0.36[0.15,0.86],總體效應(yīng)P=0.02(P0.05),說明針刺復(fù)發(fā)率小于西藥。2、對照組為中藥的3個研究(其中1個研究采用針刺VS中藥VS西藥分別對照)均采用有效率作為結(jié)局指標(biāo),Meta分析結(jié)果顯示,合并OR:1.83[0.81,4.12],總體效應(yīng)P=0.14(P0.05),針刺組與中藥組療效相當(dāng)。結(jié)論:針刺作為經(jīng)前期緊張綜合征的一種治療方法,臨床可以學(xué)習(xí)及借鑒,本研究為后續(xù)針刺治療經(jīng)前期緊張綜合征臨床研究提供一定的理論基礎(chǔ)及臨床治療經(jīng)驗(yàn)。但文獻(xiàn)的整體質(zhì)量普遍偏低,這使得研究結(jié)果的可信度在一定程度上受到影響,故有待于今后大樣本、高質(zhì)量的RCT進(jìn)行驗(yàn)證。
[Abstract]:Objective: to evaluate the clinical effect of acupuncture on premenstrual tension syndrome by META analysis. To provide certain theoretical basis and clinical treatment experience for the follow-up clinical study of acupuncture in treating premenstrual tension syndrome. Methods: based on the evidence-based study, the RCT test of acupuncture therapy for premenstrual tension syndrome in recent 16 years at home and abroad was searched. According to the results of heterogeneity test, the effect model was selected, and the relative risk risk index was chosen to express the outcome effect index. Results: a total of 865 patients were included in this study, including 9 articles on western medicine in control group and 2 articles on traditional Chinese medicine in control group. In the control group, there was one article on both traditional Chinese medicine and western medicine (this article was divided into 2 statistical analyses. Meta-analysis showed that the control group was 10 studies of western medicine (one of which was treated with acupuncture vs Chinese medicine vs western medicine respectively). Efficiency as a result of meta-analysis showed that, Combined with OR:4.23 [2.78 鹵6.44], the overall effect was P0.00001 and P0.050.The total effective rate of acupuncture group was significantly different from that of western medicine control group, and the acupuncture effect was superior to western medicine, among which four studies analyzed the headache index and the results of Meta-analysis showed that the total effective rate of acupuncture group was higher than that of western medicine group, and the total effective rate of acupuncture group was better than that of western medicine group. Headache index (MD:-4.57) [-7.14 ~ 1.72], the overall effect was 0.0002 ~ 0.05%, the curative effect of acupuncture group was better than that of western medicine group, and the recurrence rate was analyzed by two studies and the results of Meta-analysis showed that the total effect of acupuncture group was better than that of western medicine group. Combined with OR:0.36 [0.150.86], the overall effect was 0.02% P0.05A, indicating that the recurrence rate of acupuncture was lower than that of western medicine .2.The control group was three studies of traditional Chinese medicine (one of which was treated with acupuncture vs western medicine respectively) and the effective rate was used as the result index of meta-analysis. Combined with OR:1.83 [0.81 鹵4.12], the overall effect was 0.14 and P0.05.The curative effect of acupuncture group was similar to that of traditional Chinese medicine group. Conclusion: as a treatment method of premenstrual stress syndrome, acupuncture can be studied and used for reference in clinic. This study provides a certain theoretical basis and clinical treatment experience for the follow-up clinical study of acupuncture in the treatment of premenstrual tension syndrome. However, the overall quality of the literature is generally low, which makes the reliability of the results affected to some extent. So it needs to be verified by large sample and high quality RCT in the future.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.3

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