{"title":"不同针灸疗法治疗干眼症的比较：系统综述和网络荟萃分析","authors":"Qingyuan Zhang , Shenghe Huang , Qianyan Wu , Jingwen Zhang , Yao Xiao , Shuailiang Huang , Xiaogang Xu , Delin Zhang","doi":"10.1016/j.eujim.2024.102387","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Dry eye disease (DED) has become increasingly prevalent in ophthalmology, significantly impacting patients' quality of life. Despite the widespread use of acupuncture therapies in treating DED, the most effective acupuncture treatment strategy remains uncertain. This study aimed to provide guidance in clinical practice for selecting the most effective acupuncture treatment strategy using the network meta-analysis (NMA) method.</p></div><div><h3>Methods</h3><p>Seven English and Chinese databases were searched from their inception to October 15, 2023, to collect randomized controlled trials (RCTs) related to acupuncture therapies for treating DED. The risk of bias was assessed using the revised Cochrane risk of bias tool (ROB 2.0). Network meta-analysis was conducted using R 4.1.2 and Stata 17.0. The Confidence in Network Meta-Analysis (CINeMA) tool was used to evaluate the certainty of evidence.</p></div><div><h3>Results</h3><p>A total of 41 studies with 2931 participants were included. The network meta-analysis results showed that conventional acupuncture combined with thumbtack needle had the best efficacy in improving tear break-up time (TBUT) (MD = 2.95, 95 % CI [1.49, 4.39]) and Schirmer's test (MD = 3.34, 95 % CI [0.90, 5.79]). In terms of improving the corneal fluorescein staining score, conventional acupuncture combined with electroacupuncture demonstrated the best efficacy (SMD = -0.80, 95 % CI [-1.40, -0.18]). The confidence ratings of different treatment comparisons were judged as very low to low. Eight studies reported adverse effects, none of which were serious.</p></div><div><h3>Conclusion</h3><p>The NMA results support the use of acupuncture for treating DED. Among the therapies, conventional acupuncture combined with thumbtack needle and conventional acupuncture combined with electroacupuncture have higher priority. However, before widespread adoption, more multicenter, randomized, double-blind, and placebo-controlled clinical trials are needed to confirm these findings.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"70 ","pages":"Article 102387"},"PeriodicalIF":1.9000,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of different acupuncture therapies for dry eye disease: A systematic review and network meta-analysis\",\"authors\":\"Qingyuan Zhang , Shenghe Huang , Qianyan Wu , Jingwen Zhang , Yao Xiao , Shuailiang Huang , Xiaogang Xu , Delin Zhang\",\"doi\":\"10.1016/j.eujim.2024.102387\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Dry eye disease (DED) has become increasingly prevalent in ophthalmology, significantly impacting patients' quality of life. Despite the widespread use of acupuncture therapies in treating DED, the most effective acupuncture treatment strategy remains uncertain. This study aimed to provide guidance in clinical practice for selecting the most effective acupuncture treatment strategy using the network meta-analysis (NMA) method.</p></div><div><h3>Methods</h3><p>Seven English and Chinese databases were searched from their inception to October 15, 2023, to collect randomized controlled trials (RCTs) related to acupuncture therapies for treating DED. The risk of bias was assessed using the revised Cochrane risk of bias tool (ROB 2.0). Network meta-analysis was conducted using R 4.1.2 and Stata 17.0. The Confidence in Network Meta-Analysis (CINeMA) tool was used to evaluate the certainty of evidence.</p></div><div><h3>Results</h3><p>A total of 41 studies with 2931 participants were included. The network meta-analysis results showed that conventional acupuncture combined with thumbtack needle had the best efficacy in improving tear break-up time (TBUT) (MD = 2.95, 95 % CI [1.49, 4.39]) and Schirmer's test (MD = 3.34, 95 % CI [0.90, 5.79]). In terms of improving the corneal fluorescein staining score, conventional acupuncture combined with electroacupuncture demonstrated the best efficacy (SMD = -0.80, 95 % CI [-1.40, -0.18]). The confidence ratings of different treatment comparisons were judged as very low to low. Eight studies reported adverse effects, none of which were serious.</p></div><div><h3>Conclusion</h3><p>The NMA results support the use of acupuncture for treating DED. Among the therapies, conventional acupuncture combined with thumbtack needle and conventional acupuncture combined with electroacupuncture have higher priority. However, before widespread adoption, more multicenter, randomized, double-blind, and placebo-controlled clinical trials are needed to confirm these findings.</p></div>\",\"PeriodicalId\":11932,\"journal\":{\"name\":\"European Journal of Integrative Medicine\",\"volume\":\"70 \",\"pages\":\"Article 102387\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-07-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Integrative Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1876382024000568\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"INTEGRATIVE & COMPLEMENTARY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Integrative Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1876382024000568","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
导言干眼症（DED）在眼科中的发病率越来越高，严重影响了患者的生活质量。尽管针灸疗法被广泛应用于治疗 DED，但最有效的针灸治疗策略仍不确定。本研究旨在采用网络荟萃分析（NMA）方法，为临床实践中选择最有效的针灸治疗策略提供指导。方法检索了七个中英文数据库，收集了从开始到2023年10月15日与针灸疗法治疗DED相关的随机对照试验（RCT）。使用修订版科克伦偏倚风险工具（ROB 2.0）评估偏倚风险。网络荟萃分析使用 R 4.1.2 和 Stata 17.0 进行。网络荟萃分析工具（CINeMA）用于评估证据的确定性。网络荟萃分析结果显示，传统针灸结合拇指针在改善泪液破裂时间（TBUT）（MD = 2.95，95 % CI [1.49，4.39]）和Schirmer试验（MD = 3.34，95 % CI [0.90，5.79]）方面疗效最佳。在改善角膜荧光素染色评分方面，传统针灸结合电针的疗效最佳（SMD = -0.80，95 % CI [-1.40，-0.18]）。不同治疗方法比较的可信度被判定为极低至低。八项研究报告了不良反应，但均不严重。在各种疗法中，传统针灸结合拇指针和传统针灸结合电针具有更高的优先级。然而，在广泛采用之前，需要更多的多中心、随机、双盲和安慰剂对照临床试验来证实这些结果。
Comparison of different acupuncture therapies for dry eye disease: A systematic review and network meta-analysis
Introduction
Dry eye disease (DED) has become increasingly prevalent in ophthalmology, significantly impacting patients' quality of life. Despite the widespread use of acupuncture therapies in treating DED, the most effective acupuncture treatment strategy remains uncertain. This study aimed to provide guidance in clinical practice for selecting the most effective acupuncture treatment strategy using the network meta-analysis (NMA) method.
Methods
Seven English and Chinese databases were searched from their inception to October 15, 2023, to collect randomized controlled trials (RCTs) related to acupuncture therapies for treating DED. The risk of bias was assessed using the revised Cochrane risk of bias tool (ROB 2.0). Network meta-analysis was conducted using R 4.1.2 and Stata 17.0. The Confidence in Network Meta-Analysis (CINeMA) tool was used to evaluate the certainty of evidence.
Results
A total of 41 studies with 2931 participants were included. The network meta-analysis results showed that conventional acupuncture combined with thumbtack needle had the best efficacy in improving tear break-up time (TBUT) (MD = 2.95, 95 % CI [1.49, 4.39]) and Schirmer's test (MD = 3.34, 95 % CI [0.90, 5.79]). In terms of improving the corneal fluorescein staining score, conventional acupuncture combined with electroacupuncture demonstrated the best efficacy (SMD = -0.80, 95 % CI [-1.40, -0.18]). The confidence ratings of different treatment comparisons were judged as very low to low. Eight studies reported adverse effects, none of which were serious.
Conclusion
The NMA results support the use of acupuncture for treating DED. Among the therapies, conventional acupuncture combined with thumbtack needle and conventional acupuncture combined with electroacupuncture have higher priority. However, before widespread adoption, more multicenter, randomized, double-blind, and placebo-controlled clinical trials are needed to confirm these findings.
期刊介绍：
The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education.
EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians.
The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.
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