艾灸联合中药保留灌肠治疗慢性盆腔炎有效性和安全性的Meta分析OA

Objective Systematically evaluate the effectiveness and safety of moxibustion combined with traditional Chinese medicine retention enema in the treatment of chronic pelvic inflammatory disease.Methods Computer search PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure(CNKI),The China Biomedical Literature Service System(SinoMed),Wanfang Database and Chinese Science and Technology Journal Database(VIP)comprehensively collected randomized controlled trials(RCTs)involving moxibustion combined with traditional Chinese medicine retention enema for the treatment of chronic pelvic inflammatory disease from the establishment of each database until August 16,2024(whether the experimental group and control group cooperated with conventional treatment were included in the research scope).After independent literature screening and data extraction by two individuals,the Cochrane bias risk assessment tool was used to evaluate the methodological quality of the included literature.Finally,RevMan 5.4 statistical analysis software was used to conduct meta-analysis.Results A total of 13 RCTs were included,with a total of 1235 patients,including 619 in the experimental group and 616 in the control group.It should be pointed out that the selection of outcome measures for the RCTs included in this meta-analysis is relatively single,and some indicators only come from single studies,resulting in weak evidence for outcome measures.The meta-analysis results showed that the combination of moxibustion and traditional Chinese medicine retention enema treatment for chronic pelvic inflammatory disease improved the overall effective rate[RR=1.27,95%CI(1.20-1.34),P<0.01],reduced the TCM syndrome score[MD=-1.50,95%CI(-2.02--0.98),P<0.01],improved serum TNF-α levels[SMD=-2.18,95%CI(-2.63--1.72),P<0.01],improved serum IL-2 levels[SMD=3.99,95%CI(3.36-4.61),P<0.01],improved IL-10 levels[SMD=0.94,95%CI(0.57-1.32),P<0.01],and reduced plasma viscosity levels[SMD=-3.63,95%CI(-4.47--2.79,P=0.0005],reduction of erythrocyte sedimentation rate(ESR)[SMD=-0.89,95%CI(-1.42--0.36),P=0.001],quality of life score[SMD=5.37,95%CI(4.59-6.14),P<0.01],and reduction of recurrence rate[RR=0.20,95%CI(0.05-0.86),P=0.03],it is superior to using traditional Chinese medicine retention enema alone.Conclusion The combination of moxibustion and traditional Chinese medicine enema for the treatment of chronic pelvic inflammatory disease has important clinical significance and is widely used with high evaluation from doctors and patients.Based on the RCT clinical evidence included in this meta-analysis,moxibustion combined with traditional Chinese medicine retention enema is superior to using traditional Chinese medicine retention enema alone for the treatment of chronic pelvic inflammatory disease.However,it should be noted that the evidence base for some outcome measures in this meta-analysis is relatively weak,and the seven results only come from a single study.It is recommended that future studies prioritize the use of quantitative evaluation tools(such as standardized pain scales)and objective indicators related to disease progression(such as the incidence of symptom deterioration)to enhance the clinical reference value of the research results.