不同针灸疗法治疗月经性偏头痛的网状Meta分析*

作者：武薪雨1，汤 玉1，宁乙锞1，韦世杰1，韩 晶2

单位：1.山东中医药大学，山东 济南 250013；2.山东中医药大学附属医院，山东 济南 250013

引用：引用：武薪雨，汤玉，宁乙锞，韦世杰，韩晶.不同针灸疗法治疗月经性偏头痛的网状Meta分析[J].中医药导报,2025,31(5):172-177,182.

DOI：10.13862/j.cn43-1446/r.2025.05.030

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摘要：目的：通过网状Meta分析评估不同针灸疗法治疗月经性偏头痛（MM）的有效性。方法：检索中国知网（CNKI）、万方（Wanfang）、Web of Science等数据库，收集不同针灸疗法治疗MM的随机对照试验（RCT），以视觉模拟量表（VAS）评分、总有效率、偏头痛特异性生活品质量表（MSQ）评分为结局指标，使用Stata 14.0和Addis进行网状Meta分析。结果：共纳入10篇文献，包括573例患者，涉及8种干预措施（针刺、温针灸、耳穴综合疗法、针药、热敏灸、中药、假针刺及西药）。网状Meta分析结果显示，耳穴综合疗法、温针灸、针药、针刺、热敏灸、中药、假针刺降低VAS评分的效果均优于西药（P<0.05）；耳穴综合疗法降低VAS评分的效果优于针刺、假针刺（P<0.05）。耳穴综合疗法、针药降低VAS评分的效果均优于中药（P<0.05）。耳穴综合疗法、针药总有效率均优于中药（P<0.05）；耳穴综合疗法、温针灸、热敏灸、针刺总有效率均优于西药（P<0.05）。耳穴综合疗法、针刺提高MSQ评分的效果均优于西药（P<0.05）；耳穴综合疗法提高MSQ评分的效果优于假针刺（P<0.05）。VAS评分、总有效率、MSQ评分SUCRA排序均显示耳穴综合疗法为最优治疗措施的概率最大。结论：耳穴综合疗法、针药、针刺、中药、温针灸、热敏灸、假针刺、西药均可提高MM的临床疗效，其中耳穴综合疗法在降低MM发作疼痛程度，提高患者生活质量、治疗的总有效率方面表现较好。

关键词：月经性偏头痛；系统评价；网状Meta分析；针灸；耳穴综合疗法；中医

Abstract：

Objective: To evaluate the effectiveness of different acupuncture therapies for menstrual migraine (MM) through network meta-analysis. Methods: Databases including the China National Knowledge Infrastructure (CNKI), Wanfang, and Web of Science were searched to collect randomized controlled trials (RCTs) on various acupuncture therapies for MM. The visual analogue scale (VAS) score, total effective rate, and migraine-specific quality of life questionnaire (MSQ) score were used as outcome indicators, and Stata 14.0 and Addis were used for network meta-analysis. Results: A total of 10 literatures were included, involving 573 patients and 8 intervention measures (acupuncture, warm acupuncture, auricular integrative therapy, acupuncture combined with medicine, heat-sensitive moxibustion, traditional Chinese medicine, sham acupuncture, and western medicine). The results of the network meta-analysis showed that the effects of auricular integrative therapy, warm acupuncture, acupuncture combined with medicine, acupuncture, heat-sensitive moxibustion, traditional Chinese medicine, and sham acupuncture in reducing VAS scores were better than those of western medicine (P<0.05). The effect of auricular integrative therapy in reducing VAS scores was better than that of acupuncture and sham acupuncture (P<0.05). The effects of auricular integrative therapy and acupuncture combined with medicine in reducing VAS scores were better than that of traditional Chinese medicine (P<0.05). The total effective rates of auricular integrative therapy and acupuncture combined with medicine were better than that of traditional Chinese medicine (P<0.05). The total effective rates of auricular integrative therapy, warm acupuncture, heat-sensitive moxibustion, and acupuncture were better than that of western medicine (P<0.05). The effects of auricular integrative therapy and acupuncture in increasing MSQ scores were better than that of western medicine (P<0.05). The effect of auricular integrative therapy in increasing MSQ scores was better than that of sham acupuncture (P<0.05). The SUCRA rankings of VAS scores, total effective rates, and MSQ scores all showed that the auricular integrative therapy had the highest probability of being the optimal treatment measure. Conclusion: Auricular integrative therapy, acupuncture combined with medicine, acupuncture, traditional Chinese medicine, warm acupuncture, heat-sensitive moxibustion, sham acupuncture, and western medicine can all improve the clinical efficacy of MM. Among them, the auricular integrative therapy demonstrated better performance in reducing the pain intensity of MM, improving patients' quality of life, and the total effective rate of treatment.

Key words：menstrual migraine; systematic review; network meta-analysis; acupuncture; auricular integrative therapy; traditional Chinese medicine

发布时间：2025-12-31

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