针刺预防性治疗偏头痛的文献质量评价.pdfVIP

中国循证医学杂志2008，8(6)：461～465 针刺预防性治疗偏头痛的文献质量评价 张 琰 刘慧林 王麟鹏 首都医科大学附属北京中医医院针灸科(北京 100010) 摘要 目的 对针刺预防性治疗偏头痛的随机对照研究进行文献质量评价。方法 以针刺、偏头痛和预防为检 索词，检索Cochrane图书馆(2007年第4期)，MEDLINE(1966～2007)，EMbase(1966～2007)等英文数据库和 CBM(1978～2007)，CMCC(1994～2007)，CNKI(1994～2007)等中文数据库。手工检索《中国针灸》(1981～2007) 等中医杂志及有关学术会议论文汇编。对纳入文献的方法学、诊断及纳入／排除标准、针刺／对照组干预措施、疗效 评价标准及随访等方面进行评价。结果 共纳入l2篇随机对照研究，其中9篇高质量研究均为国外研究，3篇国内 研究为低质量研究，国外研究多采用偏头痛每月发作频率、天数及SF一36／SF一12等量表作为疗效评价标准，国内则采 用头痛指数计分作为疗效评价标准。9篇研究有随访记录，8篇研究报告了不良反应。结论 目前国内尚无高质量 的针刺预防性治疗偏头痛的临床研究报告，迄今所发表研究采用的疗效评价方法不能恰当评价针刺预防性治疗偏 头痛的疗效。从试验设计及实施角度，今后应多借鉴国外同类研究的长处；从临床角度，针灸医师应认清偏头痛缓 解期预防性治疗及急性期镇痛治疗的目的和意义的不同，设计出更科学的针刺预防性治疗偏头痛的试验方案。 关键词 针刺；偏头痛；预防；文献质量评价 Evaluation of the Quality of Reports on Acupuncture for Migraine Prophylaxis ZHANG Yan，LIU Hui—lin，WANG Lin—peng TheDepartmentofAcupuncture,Beijing Traditional ChineseMedicalHospital,CapitalMedical University,B嘶ing lO001G China Abstract Objectives We aimed to assess the meth0d0l0gical qual ity of RCT on acupuncture for migraine prophylaxis．Methods With the searching terms including acupuncture，migraine，prophylaxis and prevent，etc，the database of the Cochrane Library(Issue 4，2007)，MEDLINE(1966—2007)，EMBase(1966—2007)，CBM(1978—2007)and CMCC(1994—2007)were searched from their date of start publication．Chinese medical journals and relevant academic conference proceedings were hand searched as wel1．Several items in included trials were assessed，including methodology， diagnostic criteria，indusi0n／exdusi0n criteria，acupuncture／control interventions，outcome measures and follow-up，etc． Result Among the 12 included trials，9 trials overseas were high—quality and 3 in China were low-quality．Frequency or days ofmigraine attacks and SF一36／SF一12 were often evaluated as outcome measures in western countries，while headache index was used in China．Among the 1 2 trials，9 reported the follow—up outcomes and 8 mentioned adverse events