哮喘联盟

   摘要
   目的：本文旨在回顾及评估三伏天天灸疗法治疗成人哮喘的有效性和安全性。
   方法：2013年8月31日通过文献检索获取对有效率、肺功能、免疫应答、复发率、生活质量及不良事件进行评价的对照研究。检索库包括Cochrane图书馆、PubMed、EMBASE、中国知网数据库。只有采用天灸疗法治疗的随机对照试验被纳入研究。运用Cochrane Collaboration偏倚分析工具及Review Manager 5.2软件进行数据分析。
   结果：6项研究共计657名患者被纳入分析。天灸疗法比对照组更有效（优势比[OR], 3.51; 95% 置信区间 [CI], 2.05-6.00; p<0.00001; I2=18%)。与对照组相比，治疗组 IgE水平(标准化均数差 [SMD], -1.40; 95% CI, -2.18 to -0.63; p=0.0004; I2=85%) 及嗜酸性粒细胞水平(SMD, -4.26; 95% CI, -6.28 to -2.23; p<0.00001; I2=91%)下降更大。纳入本Meta分析的研究存在高偏倚风险。纳入研究几乎没有不良事件报告，不存在严重不良反应。不良事件未导致受试者退出。
   结论：所有研究显示：天灸疗法对于治疗成人哮喘有积极作用，并且因其为非侵袭性治疗而相对安全。然而现有研究的设计局限性导致高偏倚风险。需要更多方法学质量更佳的随机对照研究来进一步证实天灸疗法的有效性和安全性。
 

（苏欣 审校）
J Altern Complement Med. 2015 Mar 11. [Epub ahead of print]
 

Tian Jiu Therapy for the Treatment of Asthma in Adult Patients: A Meta-Analysis.
 

Chan CW1, Lee SC, Lo KC, Wong HK, Li L.

Author information
 

ABSTRACT
OBJECTIVES:To review and evaluate the efficacy and safety of tian jiu therapy on san fu tian for adults with asthma.
METHODS:A literature search through August 31, 2013, was done to identify comparative studies evaluating effective rate, pulmonary function, immune response, recurrence rate, quality of life, and adverse events. The Cochrane Library, PubMed, EMBASE, and Chinese National Knowledge Infrastructure were searched; only randomized controlled trials with treatment groups using tian jiu therapy were included. Cochrane Collaboration's risk of bias tool and Review Manager software, version 5.2, were used for the data synthesis.
RESULTS:Six studies involving 657 patients were identified. tian jiu therapy was more effective than the control intervention (odds ratio [OR], 3.51; 95% confidence interval [CI], 2.05-6.00; p<0.00001; I2=18%). The treatment group had a bigger decrease in IgE level (standard mean difference [SMD], -1.40; 95% CI, -2.18 to -0.63; p=0.0004; I2=85%) and Eosinophil (Eos) level (SMD, -4.26; 95% CI, -6.28 to -2.23; p<0.00001; I2=91%) compared with the control group. Included studies had a high risk of bias. Few adverse effects were reported in the included studies, and no serious adverse responses occurred. Adverse effects did not result in any dropouts.
CONCLUSIONS:All studies indicated that tian jiu therapy has a positive effect on adults with asthmaand that it is relatively safe because of its noninvasive nature. However, the limitations of the research design of the existing studies resulted in high risk of bias. More randomized controlled trials of better methodologic quality are needed to further confirm efficacy and safety of this therapy.
 

J Altern Complement Med. 2015 Mar 11. [Epub ahead of print]