目的:评价针刺治疗癫痫的有效性及安全性。方法:通过以“针刺”和“癫痫OR羊角风OR羊癫风”为检索词检索中国生物医学文献光盘数据库(CBM)、中国期刊全文数据库(CNKI)、重庆维普数据库(VIP)、万方资源数据库

以“acupuncture OR needling OR prod”and“epilepsy OR epilepsies OR seizure disorder OR single seizure”等词组合检索PubMed、Google Scholar、Cochrane Library数据库

收集针刺治疗癫痫的随机对照试验(RCT)研究资料

应用Cochrane偏倚风险评估工具对纳入文献进行质量评价

应用RevMan 5.3以及STATA 14.0软件对其总有效率效应结局指标进行分析。结果:共纳入11篇文献

合计827例患者。Meta分析显示针刺或联合其他常规药物疗法治疗癫痫的临床总疗效优于常规药物疗法

差异有统计学意义[OR=3.94

95%CI(2.49

6.24)

Z=5.85

P<0.000 01];针刺对比西药治疗癫痫各研究间有统计学异质性(P=0.04

I2=60%)

本部分不可行Meta分析;针刺联合中药优于中药治疗

差异有统计学意义[OR=4.61

95%CI(2.18

9.74)

Z=4.01

P<0.000 1];针刺联合西药优于西药

差异有统计学意义[OR=3.07

95%CI(1.24

7.65)

Z=2.41

P=0.02]。结论:临床上针刺治疗癫痫具有一定的优越性

但设计严谨、方法科学的高质量文献太少

其可靠性偏低

因此上述结果仍需要进一步验证。Objective To evaluate the efficacy and safety of acupuncture in the treatment of epilepsy.Methods We first collected research data about randomized control trials(RCTs)of acupuncture treatment of epilepsy from databases CNKI

CBM

VIP and Wanfang using key words“针刺(acupuncture)”

“癫痫(epilepsy)”or“羊角风(epilepsy)”or“羊癫风(epilepsy)”

and from PubMed

Google Scholar

and Cochrane Library using key words“acupuncture”“needling”“prod”“epilepsy”“epilepsies”or“seizure disorder”or“simple seizure”from the date of database construction to May 5

2017.Then

two researchers extracted the study outcomes and evaluated the evidence qualification of the research data independently using Cochrane risk bias assessment tool and analyzed the primary outcome indexes using RevMan 5.3and STATA 14.0.Results Eleven articles containing 827cases were included in the Meta-analysis.We found that acupuncture or acupuncture in combination with other conventional drugs had a significantly better efficacy than conventional drugs in the treatment of epilepsy[OR=3.94

95%CI(2.49

6.24)

Z=5.85

P<0.000 01].There was a statistical heterogeneity(P=0.04

I 2=60%)

and the Meta-analysis was not feasible for the studies of acupuncture vs medication.Combination of acupuncture and Chinese traditional drugs was significantly better than simple Chinese traditional drugs[OR=4.61

95%CI(2.18

9.74)

Z=4.01

P<0.000 1]

and combination of acupuncture and western medicines was obviously better than simple western medicines[OR=3.07

95%CI(1.24

7.65)

Z=2.41

P=0.02]in the treatment of epilepsy.Conclusion Acupuncture therapy may have a positive effect in the treatment of epilepsy but the conclusion needs further verification due to very fewer high-quality and well-designed RCTs found at the present.