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天津中医药大学第一附属医院,天津 300381
国家中医针灸临床医学研究中心,天津 300381
天津中医药大学研究生院,天津 301617
张艺萱,天津中医药大学硕士研究生。E-mail:zhangyix1024@163.com
✉韩林,副主任医师。E-mail:tjhanlin@163.com
收稿:2024-07-11,
网络首发:2024-11-28,
纸质出版:2025-08-12
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张艺萱, 杨蕊, 张春畅, 等. 针灸治疗次数与颈性眩晕疗效的量效关系:基于随机对照试验的Meta回归分析[J]. 中国针灸, 2025,45(8):1180-1186.
ZHANG Yixuan, YANG Rui, ZHANG Chunchang, et al. Dose-effect relationship between the number of acupuncture sessions and efficacy for cervical vertigo: a Meta-regression analysis based on randomized controlled trials[J]. Chinese Acupuncture & Moxibustion, 2025, 45(8): 1180-1186.
张艺萱, 杨蕊, 张春畅, 等. 针灸治疗次数与颈性眩晕疗效的量效关系:基于随机对照试验的Meta回归分析[J]. 中国针灸, 2025,45(8):1180-1186. DOI: 10.13703/j.0255-2930.20240711-0002.
ZHANG Yixuan, YANG Rui, ZHANG Chunchang, et al. Dose-effect relationship between the number of acupuncture sessions and efficacy for cervical vertigo: a Meta-regression analysis based on randomized controlled trials[J]. Chinese Acupuncture & Moxibustion, 2025, 45(8): 1180-1186. DOI: 10.13703/j.0255-2930.20240711-0002.
目的:
2
探讨针灸次数与颈性眩晕(CV)疗效之间的量效关系。
方法:
2
检索建库至2024年6月28日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)、Web of Science、PubMed中针灸治疗CV的随机对照试验文献,研究对象采用单纯针灸治疗,选穴以“百会-风池-颈夹脊”为核心处方,结局指标包括颈性眩晕症状与功能评估量表(ESCV)评分及椎-基底动脉平均血流速度。采用Cochrane偏倚风险评估工具2.0评价其文献质量,通过Stata17.0软件中稳健误差元回归(REMR)方法进行针灸次数与疗效间的量效Meta回归分析。
结果:
2
共纳入19篇文献,试验组共747例患者。10次针灸治疗后,患者ESCV评分升高至20.29(95%
CI
:16.77,23.80),治疗前后ESCV差值为4.60(95%
CI
: 2.59,6.60),ESCV评分改善率为0.36(95%
CI
: 0.26,0.46);20次针灸治疗后,ESCV评分提高至21.55(95%
CI
: 18.87,24.22),ESCV评分差值为5.42(95%
CI
: 3.87,6.97),ESCV评分改善率为0.39(95%
CI
: 0.31,0.48)。10次针灸治疗后,左侧椎动脉(LVA)平均血流速度改善率为0.08(95%
CI
: 0.05,0.12),右侧椎动脉(RVA)平均血流速度改善率为0.09(95%
CI
: 0.05,0.12),基底动脉(BA)平均血流速度改善率为0.11(95%
CI
: 0.06,0.15);14次针灸治疗后,LVA、RVA、BA平均血流速度改善率均达到最高值:LVA[0.09(95%
CI
: 0.06,0.12)
]
、RVA[0.10(95%
CI
: 0.07,0.13)
]
、BA[0.12(95%
CI
: 0.07,0.16)
]
。
结论:
2
针灸次数与CV疗效之间存在非线性的量效关系,推荐14次为最佳针灸治疗次数。
Objective
2
To explore the dose-effect relationship between the number of acupuncture sessions and the efficacy for cervical vertigo (CV).
Methods
2
Literature regarding randomized controlled trials (RCTs) of acupuncture for CV was retrieved from CNKI
Wanfang
VIP
Web of Science
and PubMed databases from inception to June 28th
2024. Studies were included if patients were treated solely with acupuncture and the core prescription included Baihui (GV20)-Fengchi (GB20)-neck-jiaji (EX-B2). Outcomes included the evaluation scale for cervical vertigo symptoms and function (ESCV) score and the mean blood flow velocity of vertebrobasilar arteries. The Cochrane risk of bias assessment tool 2.0 was used to evaluate study quality. Dose-effect Meta-regression analysis was performed using the robust-error Meta-regression (REMR) method in Stata 17.0 software.
Results
2
Nineteen RCTs were included with a total of 747 patients in the experimental groups. After 10 sessions of acupuncture
the ESCV score increased to 20.29 (95%
CI
: 16.77
23.80)
with a pre-post ESCV difference of 4.60 (95%
CI
: 2.59
6.60) and an improvement rate of 0.36 (95%
CI
: 0.26
0.46). After 20 sessions of acupuncture
the ESCV score increased to 21.55 (95%
CI
: 18.87
24.22)
with a difference of 5.42 (95%
CI
: 3.87
6.97) and an improvement rate of 0.39 (95%
CI
: 0.31
0.48). After 10 sessions of acupuncture
the improvement rates for left vertebral artery (LVA)
right vertebral artery (RVA)
and basilar artery (BA) mean blood flow velocities were 0.08 (95%
CI
: 0.05
0.12)
0.09 (95%
CI
: 0.05
0.12)
and 0.11 (95%
CI
: 0.06
0.15)
respectively. After 14 sessions of acupuncture
the improvement rates reached their peaks: LVA [0.09 (95%
CI
: 0.06
0.12)
]
RVA [0.10 (95%
CI
: 0.07
0.13)
]
and BA [0.12 (95%
CI
: 0.07
0.16)
]
.
Conclusion
2
A nonlinear dose-effect relationship existed between the number of acupuncture sessions and the efficacy for CV. Fourteen sessions were recommended as the optimal number of acupuncture treatments.
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