本文選題：針灸 + 慢性咽炎　； 參考：《成都中醫(yī)藥大學》2016年碩士論文

【摘要】：目的：檢索2016年1月前針灸方法治療慢性咽炎(排除急性咽炎)的臨床隨機對照試驗(Randomized Controlled Trials, RCT),納入針灸或針灸聯(lián)合藥物與藥物治療慢性咽炎來對照的RCT研究,通過系統(tǒng)評價對針灸改善慢性咽炎臨床癥狀的療效采取評價,分析臨床取穴規(guī)律,為針灸治療慢性咽炎的臨床運用提供循證醫(yī)學依據(jù)。方法：文獻檢索：檢索國內外數(shù)據(jù)庫：①中文數(shù)據(jù)庫：計算機檢索中國知網(1995-2016)、維普數(shù)據(jù)庫(1995-2016)、萬方數(shù)字化期刊(2016年1月1日以前)以及中國生物醫(yī)學文獻數(shù)據(jù)庫(1995-2016)；②英文數(shù)據(jù)庫：The Cochrane Library (2016), PubMed (1995-2016); EMBASE (1995-2016);③手工檢索本校圖書館相關資料；④ http://scholar.google.com等網絡資料、灰色文獻數(shù)據(jù)庫和會議文獻數(shù)據(jù)庫(CMCC)上進行補充檢索。確定文獻：由兩名系統(tǒng)評價員按照本系統(tǒng)評價的診斷、納入及排除標準,對資料進行提取,選出所有針灸或者針灸聯(lián)合藥物治療慢性咽炎的臨床隨機對照實驗,如遇到問題存在分歧,通過討論或由其他方仲裁解決。數(shù)據(jù)分析：對納入的文獻依據(jù)評價員手冊(5.1.0)和GRADE證據(jù)等級進行文獻質量評價,再通過Cochrane協(xié)作網專用統(tǒng)計軟件包(Review Manager 5.3.5),進行定性和meta分析。結果：(1)總共納入21篇符合標準的文獻,其總樣本量為2200例受試者,試驗組1145例,對照組1055例。按照干預措施分組,針灸與藥物對照12篇,針灸結合基礎治療與基礎治療對照9篇；(2)主要結局指標總有效率分析,針灸與藥物對照組RR=1.29,95%CI[1.22,1.36],針灸結合基礎治療與基礎治療對照組RR=1.18,95%CI[1.11,1.25];治愈率分析,針灸與藥物對照組RR=1.97,95%CI[1.66,2.34],針灸結合基礎治療與基礎治療對照組RR=1.51,95%CI[1.27,1.81];(3)對針灸治療慢性咽炎后血管內皮細胞黏附分子(VCAM-1)及血清IL-2、TNF-a進行定性分析。結論：(1)基礎治療的前提下,增加針灸療法能提高臨床總有效率及治愈率,改善癥狀與體征,證據(jù)等級為中級,給予推薦；(2)針灸療法比西藥更能提高慢性咽炎的總有效率及治愈率,證據(jù)等級為中級,給予推薦；(3)基礎治療前提下,加用針灸療法可以改善咽喉部癥狀量表評分,但量表不夠規(guī)范,證據(jù)等級不高,有待進一步研究改善；(4)針灸療法在改善慢性咽炎血管內皮細胞黏附分子(VCAM-1)及血清IL-2、TNF-a比藥物療法更有優(yōu)勢,證據(jù)等級均為低級或者極低級,其臨床可靠性不能評估,只能為臨床提供參考,有待以后對此深入研究；(5)由于缺乏不良反應數(shù)據(jù),無法對針灸治療慢性咽炎安全性作出客觀評價。
[Abstract]:Objective: to retrieve randomized Controlled trials (RCTs) of acupuncture and moxibustion therapy for chronic pharyngitis (excluding acute pharyngitis) before January 2016, and to include the RCT study of acupuncture and moxibustion combined with drugs and drugs in the treatment of chronic pharyngitis. The clinical effect of acupuncture and moxibustion on improving the clinical symptoms of chronic pharyngitis was evaluated through systematic evaluation, and the rule of acupoint collection was analyzed to provide evidence based medicine basis for the clinical application of acupuncture and moxibustion in the treatment of chronic pharyngitis. Methods: literature retrieval: retrieval of domestic and foreign databases: 1 Chinese database: computer retrieval of China Zhiwang (1995-2016), Weipu (1995-2016), Wanfang digital journals (before January 1, 2016) and Chinese biomedical literature database (1995-2016); (2) English database: the Cochrane Library / 2016, PubMed / 1995 / 2016; EMBASE / 1995 / 2016 / 3; 4 http://scholar.google.com and other network data, gray document database and conference document database were used for supplementary retrieval. To confirm the literature: according to the diagnosis, inclusion and exclusion criteria of the system, two systematic evaluators were selected to select all clinical randomized controlled trials of acupuncture and moxibustion combined with drugs for the treatment of chronic pharyngitis. In the event of any disagreement, the dispute shall be settled by discussion or arbitration by other parties. Data analysis: the literature quality was evaluated on the basis of the evaluator's manual 5.1.0) and the GRADE evidence grade, and then the qualitative and meta analysis was carried out through the special statistical software package of Cochrane cooperation network (Review Manager 5.3.5). Results A total of 21 articles were included. The total sample size was 2200 subjects, 1145 subjects in the trial group and 1055 in the control group. According to the intervention measures, there were 12 articles of acupuncture and drug control, 9 articles of acupuncture combined with basic treatment and 9 pieces of basic treatment. The total effective rate of the main outcome indexes was analyzed. The CI of acupuncture and moxibustion and drug control group was 1.2995 [1.221.36], and that of the control group of acupuncture and moxibustion combined with basic therapy was 1.18995 CI [1.111.25], and the cure rate was analyzed. The quantitative analysis of vascular endothelial cell adhesion molecule (VCAM-1) and serum IL-2TNF-a after chronic pharyngitis treated by acupuncture and moxibustion combined with basic therapy and basic therapy was carried out. Conclusion under the premise of basic treatment, the increase of acupuncture and moxibustion therapy can improve the total clinical effective rate and cure rate, improve the symptoms and signs, and the level of evidence is intermediate. The total effective rate and cure rate of chronic pharyngitis can be improved by acupuncture and moxibustion therapy than western medicine. The evidence grade is intermediate. Under the premise of recommended basic treatment, acupuncture and moxibustion therapy can improve the score of pharynx and larynx symptom scale. However, the scale is not standardized and the evidence level is not high. Further research is needed to improve the Acupuncture therapy in the improvement of vascular endothelial cell adhesion molecule (VCAM-1) and serum IL-2TF-a in chronic pharyngitis. Its clinical reliability can not be evaluated, can only provide a reference for clinical practice, and need to be further studied in the future. (5) due to the lack of adverse reaction data, it is impossible to make an objective evaluation on the safety of acupuncture and moxibustion in the treatment of chronic pharyngitis.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.81

【參考文獻】

相關期刊論文 前10條

1 谷巍;畢寶曰;金小仙;常宇;孔陽;;針刺治療慢性咽炎臨床觀察[J];廣州中醫(yī)藥大學學報;2016年01期

2 朱青霞;郜旭娜;;針刺“喉部兩穴”治療慢性咽炎的臨床療效觀察[J];中醫(yī)臨床研究;2015年04期

3 薛利鳳;苗玉新;;針灸配合中藥治療慢性咽炎臨床療效觀察[J];中國實用醫(yī)藥;2014年36期

4 朱崇安;羅云波;;針灸治療慢性咽炎的臨床研究[J];針灸臨床雜志;2014年08期

5 李唯溱;王海榮;;針刺天突穴治療慢性咽炎32例[J];上海針灸雜志;2014年06期

6 李紅霞;張文歧;楊濤;;針灸治療慢性咽炎療效觀察[J];醫(yī)藥論壇雜志;2013年08期

7 侯春英;趙耀東;田永萍;;針刺利咽穴治療陰虛肺燥型慢性咽炎30例[J];西部中醫(yī)藥;2013年06期

8 陳改娥;張鐵英;劉莉萍;候薇;張根養(yǎng);高新;趙君麗;;刺刮法治療慢性咽炎60例[J];陜西中醫(yī);2013年04期

9 張宏如;符仲華;顧一煌;;浮針治療慢性咽炎31例[J];中國針灸;2013年03期

10 汪衛(wèi)東;;臨床憶溯性研究與回顧性研究方法對比[J];中國中醫(yī)基礎醫(yī)學雜志;2013年01期

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