摘要
目的: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: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: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: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 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 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 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 CRADE 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 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.
作者
陆晓菲
陶雅文
刘凡
徐玉芹
龚明强
杨卓欣
LU Xiao-fei;TO Ya-wen;LIU Fan;XU Yu-qin;GONG Ming-qiang;YANG Zhuo-xin(Fourth Clinical Medical College of Guangzhou University of CM,Shenzhen 518000,Guangdong Province,China;Department of Acupuncture and Moxibustion,Shenzhen TCM Hospital,Shenzhen 518000,Guangdong Province)
出处
《中国针灸》
CAS
CSCD
北大核心
2023年第10期1209-1216,共8页
Chinese Acupuncture & Moxibustion
基金
“三名工程”中国中医科学院刘保延首席研究员中医针灸临床评价方法创新团队:SZSM201612001。
