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1.广州中医药大学第四临床医学院,广东深圳518000
2.深圳市中医院针灸科,广东深圳518000
杨卓欣,教授、主任医师。E-mail: 001188@gzucm.edu.cn
收稿:2022-10-08,
网络首发:2023-08-07,
纸质出版:2023-10-12
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陆晓菲,陶雅文,刘凡等.针灸治疗小儿脑瘫疗效的系统评价再评价[J].中国针灸,2023,43(10):1209-1216.
LU Xiao-fei,TAO Ya-wen,LIU Fan,et al.Re-evaluation of systematic reviews of acupuncture and moxibustion for children with cerebral palsy[J].Chinese Acupuncture & Moxibustion,2023,43(10):1209-1216.
陆晓菲,陶雅文,刘凡等.针灸治疗小儿脑瘫疗效的系统评价再评价[J].中国针灸,2023,43(10):1209-1216. DOI: 10.13703/j.0255-2930.20221008-0004.
LU Xiao-fei,TAO Ya-wen,LIU Fan,et al.Re-evaluation of systematic reviews of acupuncture and moxibustion for children with cerebral palsy[J].Chinese Acupuncture & Moxibustion,2023,43(10):1209-1216. DOI: 10.13703/j.0255-2930.20221008-0004.
目的
2
对针灸治疗小儿脑瘫疗效的Meta分析和系统评价进行方法学质量、报告质量和证据质量评价,为临床决策提供参考。
方法
2
计算机检索中国期刊全文数据库(CNKI)、万方数据知识服务平台(Wanfang)、维普资讯中文期刊服务平台(VIP)、中国生物医学文献服务系统(SinoMed)、Cochrane Library、PubMed 和EMbase数据库,收集针灸治疗小儿脑瘫疗效的系统评价/Meta分析,检索时间为建库至2022年6月30日。使用AMSTAR 2量表评估文献的方法学质量,使用PRISMA量表对文献报告质量进行评分,使用GRADE量表对证据质量进行分级。
结果
2
最终纳入14篇系统评价,共37个结局指标,通过AMSTAR 2评价纳入文献的方法学质量,4篇为低质量,10篇为极低质量文献,得分较差的条目为2、4、7、10、16。PRISMA评分为15~25分,报告质量问题主要体现为结构式摘要、方案和注册、检索、资金等方面。GRADE分级结果显示,高质量证据3个,中等质量证据7个,低质量证据10个,极低质量证据17个,降级因素主要为局限性、不精确性及发表偏倚。
结论
2
针灸治疗小儿脑瘫有一定疗效,但纳入文献的方法学质量、报告质量、证据质量均较差,且不同针灸方法之间的疗效比较尚不明确。
Objective
2
To assess the methodological quality
report quality and evidence quality of the Meta-analysis and systematic reviews of acupuncture and moxibustion for children with cerebral palsy
aiming to provide decision-making basis for clinical treatment.
Methods
2
The systematic reviews and Meta-analysis of acupuncture and moxibustion for children with cerebral palsy were searched in CNKI
Wanfang
VIP
SinoMed
Cochrane Library
PubMed and EMbase. The retrieval time was from the database establishment to June 30th
2022. AMSTAR 2 (a measurement tool to assess systematic reviews) was used to evaluate the methodological quality, and PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality
and GRADE was used to evaluate the quality of evidence.
Results
2
A total of 14 systematic reviews were included
including 37 primary outcome indexes. According to AMSTAR 2 evaluation results
there were 4 low quality studies
10 very low quality studies
and low scores on items 2
4
7
10 and 16. PRISMA scores ranged from 15 to 25
and the main reporting problems reflected in structured abstracts
program and registration
retrieval
and funding sources
etc. According to the GRADE classification results
there were 3 high quality evidences
7 medium quality evidences
10 low quality evidences and 17 very low quality evidences. The main downgrading factors were limitations
imprecision and publication bias.
Conclusion
2
Acupuncture and moxibustion has a certain effect for cerebral palsy in children
but the quality of methodology
reporting and evidence in the included literature is poor
and the comparison of curative effect between different acupuncture and moxibustion methods is unclear.
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