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1.中国中医科学院西苑医院,北京市海淀区西苑操场1号,100091
2.北京中医药大学研究生院
3.山东中医药大学附属医院
4.陕西中医药大学附属医院
Received:11 May 2021,
Revised:2021-07-18,
Published:17 March 2022
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樊雪鸣,申伟,魏竞竞等.针刺治疗紧张型头痛临床研究的概括性评价[J].中医杂志,2022,63(06):572-580.
FAN Xueming,SHEN Wei,WEI Jingjing,et al.Acupuncture for Tension-type Headache: A Scoping Review of Clinical Studies[J].Journal of Traditional Chinese Medicine,2022,63(06):572-580.
樊雪鸣,申伟,魏竞竞等.针刺治疗紧张型头痛临床研究的概括性评价[J].中医杂志,2022,63(06):572-580. DOI: 10.13288/j.11-2166/r.2022.06.014.
FAN Xueming,SHEN Wei,WEI Jingjing,et al.Acupuncture for Tension-type Headache: A Scoping Review of Clinical Studies[J].Journal of Traditional Chinese Medicine,2022,63(06):572-580. DOI: 10.13288/j.11-2166/r.2022.06.014.
目的
2
对针刺治疗紧张型头痛(TTH)临床研究文献进行概括性评价,了解该领域的研究现状。
方法
2
计算机检索8个中英文医学文献数据库和2个临床研究注册系统,检索时限为各数据库建库至2020年9月13日。纳入针刺治疗TTH的临床原始研究和系统评价,对临床研究的发表年度趋势、研究类型、疾病分型和中医辨证分型、针刺治疗方案、针刺干预疗程、结局指标等进行总结分析;运用AMSTAR量表对系统评价的质量进行评价,并对结论进行分析。
结果
2
共纳入文献247篇,其中临床研究238篇,系统评价9篇。自2011年以来针刺治疗TTH的临床研究数量有所增加。纳入的临床研究类型以随机对照试验为主,共187篇。针刺治疗方案以普通针刺为主,共110篇;特殊方案针刺以电针多见,共20篇。临床有效率、头痛程度、头痛持续时间、头痛发作次数、头痛伴随症状是现有临床研究关注较多的结局指标。纳入的9篇系统评价中中等质量(4~7分)的6篇,高质量(8~11分)的3篇。7篇缺乏前期设计方案、不能提供排除文献清单。8篇系统评价结论支持针刺治疗的临床疗效。
结论
2
现有临床研究显示了针刺对TTH的治疗优势,但缺乏具有中医药特色的评价指标,且在精神心理、行为特征等方面关注较少。此外,针刺治疗的证据质量普遍不高,临床疗效尚需明确。
Objective
2
To conduct a scoping review of the clinical studies on acupuncture in the treatment of tension-type headache (TTH) and to understand the current status of research in this field.
Methods
2
Eight Chinese and English medical databases and two clinical trial registry systems were electronically searched from the inception dates to September 13th, 2020. The original clinical studies and systematic reviews (SRs) of acupuncture for TTH were included. The annual publication trend, study types, disease types, traditional Chinese medicine (TCM) syndrome types, acupuncture program, acupuncture course, outcome indicators were analyzed. The quality of the SRs was evaluated using the AMSTAR scale, and the conclusions were analyzed.
Results
2
A total of 247 studies were included, involving 238 original clinical studies and 9 SRs. The number of original clinical studies has increased since 2011. The major study type was randomized controlled trial (187 studies). The conventional acupuncture was mostly explored (110 studies), and for non-conventional acupuncture, electroacupuncture was commonly used (20 studies). The most frequently used outcome indicators were clinical effective rate, degree of headache, duration of headache, number of headache attacks, and the accompanying symptoms of headache. Of the included SRs, six were of moderate quality (4-7 points) and three were of high quality (8-11 points). Seven SRs lacked protocols and could not provide the list of the excluded studies. The conclusions of eight SRs supported the effectiveness of acupuncture in the treatment of TTH.
Conclusion
2
Current clinical studies have shown the effectiveness of acupuncture in the treatment of TTH, but TCM-specific indicators as well as psychological and behavioral outcome indicators are lacked. Moreover, as the quality of the evidence is generally low, more qualified studies are needed to confirm the effectiveness of acupuncture in the treatment of TTH.
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