上海中医药大学科技信息中心,上海市浦东新区蔡伦路1200号,201203
xjj1100@126.com
收稿:2022-01-21,
修回:2022-09-29,
纸质出版:2022-12-17
移动端阅览
崔唐明,张怡颖,许吉.世界卫生组织国际临床试验注册平台针灸治疗疼痛临床试验注册情况分析[J].中医杂志,2022,63(24):2332-2338.
CUI Tangming,ZHANG Yiying,XU Ji.Registration Status of Clinical Trials Exploring Acupuncture and Moxibustion for Treatment of Pain on the WHO International Clinical Trial Registry Platform[J].Journal of Traditional Chinese Medicine,2022,63(24):2332-2338.
崔唐明,张怡颖,许吉.世界卫生组织国际临床试验注册平台针灸治疗疼痛临床试验注册情况分析[J].中医杂志,2022,63(24):2332-2338. DOI: 10.13288/j.11-2166/r.2022.24.007.
CUI Tangming,ZHANG Yiying,XU Ji.Registration Status of Clinical Trials Exploring Acupuncture and Moxibustion for Treatment of Pain on the WHO International Clinical Trial Registry Platform[J].Journal of Traditional Chinese Medicine,2022,63(24):2332-2338. DOI: 10.13288/j.11-2166/r.2022.24.007.
目的
2
总结2017至2021年针灸治疗疼痛相关临床研究的注册情况,分析该领域研究现状和热点。
方法
2
检索世界卫生组织国际临床试验注册平台(WHO ICTRP)2017年1月1日至2021年6月30日期间注册的针灸治疗疼痛的相关试验。提取纳入研究的注册时间、试验完成情况、注册中心与申请国家等基本信息和试验设计、疾病类型、干预措施、结局指标等信息,并进行统计与分析。
结果
2
最终纳入针灸治疗疼痛的相关试验519项。纳入试验中,已完成项目94项(18.11%),其中上传试验结果的仅15项;涉及的临床试验注册中心有13个,注册数量前五位的为中国临床试验注册中心(ChiCTR,234项)、美国临床试验注册中心(ClinicalTrials.gov,158项)、伊朗临床试验注册中心(IRCT,32项)、韩国临床研究信息服务中心(CRIS,27项)、巴西临床试验注册中心(REBEC,17项)。研究申请数量前五位的国家依次为中国(310项)、美国(45项)、伊朗(35项)、韩国(34项)、巴西(21项)。研究设计方面,干预性研究共495项,其中433项(87.47%)为平行组研究,观察性研究21项,其中最多的为病例对照研究(9项,42.86%)。随机对照试验有323项,259项报道了随机方法,255项试验使用了盲法。根据ICD-11疼痛分类,纳入试验研究对象涉及慢性疼痛的有419项,其中以慢性继发性肌肉骨骼疼痛(143项)与慢性原发性疼痛(138项)居多;研究对象为急性疼痛的96项,其中急性术后疼痛(73项)最多。纳入研究共涉及134类病症,分属20个系统,其中肌肉骨骼系统或结缔组织疾病(181项)最多。干预措施较为多样化,单纯采用针刺方法的项目最多(206项),其次是针刺、电针等与药物、运动锻炼、常规护理等结合的项目(106项)。519项试验中,视觉模拟量表(VAS)(347项,66.86%)、数字疼痛评分法(NRS)(56项,10.79%)、McGiLL疼痛问卷(24项,4.62%)是观察疼痛疗效的最常用的主要结局指标。
结论
2
近年针灸治疗疼痛研究项目结果公开度低、研究设计质量仍需提高。慢性疼痛、术后镇痛是针灸治疗疼痛临床试验的主要关注点。
Objective
2
To summarize the registration status of pain-related acupuncture-moxibustion researches registered from 2017 to 2021, and to analyze the research status and hotspots in this field.
Methods
2
The World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) was retrieved from January 1st, 2017 to June 30th, 2021 for relevant trials on acupuncture and moxibustion for treatment of pain. The basic information such as registration date, trial completion status, registration center and country, as well as trial design, disease type, intervention, outcome indicators and other information were extracted and statistically analyzed.
Results
2
A total of 519 trials exploring acupuncture and moxibustion for treatment of pain were finally included. Among the included trials, 94 trials (18.11%) have been completed, of which only 15 trials have uploaded the results. Thirteen clinical trial registries were involved, and Chinese Clinical Trial Registry (ChiCTR, 234 trials), ClinicalTrials.gov (158 trials), Iran Registry of Clinical Trials (IRCT, 32 trials), Clinical Research Information Service (CRiS) of Republic of Korea (27 trials), and The Brazilian Registry of Clinical Trials (ReBEC, 17 trials) were the top five registries with most number of included trials. In terms of the countries, China (310 trials), the United States (45 trials), Iran (35 trials), the Republic of Korea (34 trials), and Brazil (21 trials) contributed most trials.Regarding the design, there were 495 interventional studies of which 433 studies (87.47%) adopted parallel groups, and there were 21 observational studies, mostly case control studies (9 studies, 42.86%). there were 323 randomized controlled trials (RCTs), among which 259 RCTs reported the randomization method, and 255 RCTs used blinding. According to ICD-11, 419 studies explored chronic pain, mainly chronic secondary musculoskeletal pain (143 stu-dies) and chronic primary pain (138 studies), while 96 studies put focus on acute pain, mainly acute postoperative pain (73 studies). The included studies involved a total of 134 diseases belonging to 20 systems, among which the musculoskeletal system or connective tissue diseases (181 studies) were mostly explored. Interventions were diversed, and acupuncture alone was mostly reported (206 studies), followed by acupuncture or electroacupuncture in combination with drugs, exercises or routine care (106 studies). The most commonly used primary outcome measurement tools for pain were Visual Analog Scale (VAS) (347 studies, 66.86%), Numerical Pain Scale (NRS) (56 studies, 10.79%), and McGiLL Pain Questionnaire (24 studies, 4.62%).
Conclusion
2
In recent years, the publicity of the results of acupuncture and moxibustion researches for pain is low, and the design still needs to be improved. Chronic pain and postoperative analgesia are the main focus of acupuncture and moxibustion researches for treatment of pain.
Iternational Association for the Study of Pain . Terminology [EB/OL].( 2019-01-10 )[ 2022-09-28 ]. https://www.iasp-pain.org/terminology?navItemNumber=576#Pain https://www.iasp-pain.org/terminology?navItemNumber=576#Pain .
HENSCHKE N , KAMPER SJ , MAHER CG . The epidemiology and economic consequences of pain [J]. Mayo Clin Proc , 2015 , 90 ( 1 ): 139 - 147 .
KELLY RB , WILLIS J . Acupuncture for pain [J]. Am Fam Physician , 2019 , 100 ( 2 ): 89 - 96 .
PROEHL JA , ALEXANDER S , MANTON AP . Integrity and transparency in reporting clinical trials [J]. Adv Emerg Nurs J , 2017 , 39 ( 1 ): 1 - 2 .
ABAID LN , GRIMES DA , SCHULZ KF . Reducing publication bias of prospective clinical trials through trial registration [J]. Contraception , 2007 , 76 ( 5 ): 339 - 341 .
于河 , 刘建平 . 国际临床试验注册概述 [J]. 中西医结合学报 , 2007 , 5 ( 3 ): 234 - 242 .
邬兰 , 田国祥 , 王行环 , 等 . 临床试验的注册及注册平台比较分析 [J]. 中国循证心血管医学杂志 , 2017 , 9 ( 2 ): 129 - 134 .
GOLDACRE B . The WHO joint statement from funders on trials transparency [J]. BMJ , 2017 , 357 : j2816 . doi: 10.1136/bmj.j2816 http://dx.doi.org/10.1136/bmj.j2816 .
梁繁荣 , 王华 . 针灸学(新世纪第4版) [M]. 北京 : 中国中医药出版社 , 2016 : 135 - 189 .
世界卫生组织 . 用于死因与疾病统计的ICD-11 [EB/OL].( 2021-05-01 )[ 2022-01-05 ]. https://icd.who.int/browse11/l-m/zh#/http://id.who.int/icd/entity/107534985 https://icd.who.int/browse11/l-m/zh#/http://id.who.int/icd/entity/107534985 .
孙振球 . 医学统计学 [M]. 北京 : 人民卫生出版社 , 2007 : 508-509,591-594 .
International Committee of Medical Journal Editors . Cli-nical Trials Registration:Which trials registries areacceptable to the ICMJE? [EB/OL].( 2013-12-30 )[ 2022-01-05 ]. http://www.icmje.org/about-icmje/faqs/clinical-trials-registration/ http://www.icmje.org/about-icmje/faqs/clinical-trials-registration/ .
曹伯旭 , 林夏清 , 吴莹 , 等 . 慢性疼痛分类目录和定义 [J]. 中国疼痛医学杂志 , 2021 , 27 ( 1 ): 2 - 8 .
毛鹏 , 林夏清 , 李怡帆 , 等 . 慢性继发性肌肉骨骼疼痛 [J]. 中国疼痛医学杂志 , 2021 , 27 ( 5 ): 323 - 326 .
李政杰 , 刘迈兰 , 王君南 , 等 . 针灸临床研究的国际注册方法及现状 [J]. 针刺研究 , 2012 , 37 ( 1 ): 86 - 87 .
银子涵 , 孙铭声 , 徐桂兴 , 等 . 2014-2018年WHO ICTRP针灸临床试验注册情况分析 [J]. 中国循证医学杂志 , 2019 , 19 ( 12 ): 1395 - 1399 .
陈君超 . 从试验注册到结果公开进一步提高临床试验的透明化 [J]. 中国新药杂志 , 2018 , 27 ( 20 ): 2357 - 2360 .
MOORTHY VS , KARAM G , VANNICE KS , et al . Rationale for WHO's new position calling for prompt reporting and public disclosure of interventional clinical trial results [J]. PLoS Med , 2015 , 12 ( 4 ): e1001819 .
中国临床试验注册中心 . 关于共享临床试验原始数据(IPD)的公告 [EB/OL].( 2016-03-14 )[ 2022-10-31 ]. http://www.chictr.org.cn/uploads/documents/201801/6805c684f6ac4e4d8dae96ef8964d2a7 http://www.chictr.org.cn/uploads/documents/201801/6805c684f6ac4e4d8dae96ef8964d2a7 .
刘彩娇 , 陈芷涵 , 李思静 , 等 . 近10年针灸临床随机对照试验研究热点与前沿可视化分析 [J]. 中国针灸 , 2022 , 42 ( 2 ): 221 - 226 .
曾宪涛 , 黄伟 , 沈可 . Meta分析系列之十一:随机化的评价 [J]. 中国循证心血管医学杂志 , 2013 , 5 ( 2 ): 101 - 103 .
屠健如 . 关于针灸随机对照试验中发表偏倚原因的研究 [J]. 中国针灸 , 2010 , 30 ( 7 ): 601 - 608 .
VICKERS AJ , LINDE K . Acupuncture for chronic pain [J]. JAMA , 2014 , 311 ( 9 ): 955 - 956 .
中华医学会骨科学分会 . 骨关节炎诊治指南(2007年版) [J]. 中国临床医生杂志 , 2008 , 36 ( 1 ) : 28 - 30 .
中国针灸学会 . 循证针灸临床实践指南:膝骨关节炎 [M]. 北京 : 中国中医药出版社 , 2015 : 1 .
徐培 , 阚厚铭 , 程志祥 , 等 . 针刺疗法在术后疼痛治疗中的应用现状 [J]. 中国疼痛医学杂志 , 2021 , 27 ( 5 ): 372 - 375 .
LI X , WANG R , SHI X , et al . Reporting characteristics and risk of bias in randomised controlled trials of acupuncture analgesia published in PubMed-listed journals [J]. Acupunct Med , 2017 , 35 ( 4 ): 259 - 267 .
王志刚 . 针刺对全膝关节置换术后患膝关节功能恢复的影响 [D]. 天津 : 天津中医药大学 , 2021 .
陈巧玲 , 黄双英 . 腕踝针治疗膝关节置换术后疼痛疗效观察 [J]. 上海针灸杂志 , 2012 , 31 ( 5 ): 330 - 331 .
徐海霞 , 罗海霞 . 揿针针刺内关穴、合谷穴对骨科手术患者术后疼痛及恶心呕吐的影响 [J]. 河南中医 , 2021 , 41 ( 2 ): 271 - 274 .
李宛凌 , 陈蕾 . 临床试验注册概述及其在神经病学领域的应用 [J]. 华西医学 , 2018 , 33 ( 6 ): 758 - 761 .
0
浏览量
8
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号