| Purpose:The systematic evaluation of evidence-based medicine was used to evaluate the safety and effectiveness of meridian-selected acupuncture in the treatment of chronic stable angina pectoris.Methods:A total of published randomized controlled trials(RCTs)of acupoint selection along meridians in the treatment of chronic stable angina pectoris were collected through computer retrieval of Pub Med,CNKI,Wanfang,VIP and artificial retrieval of the relevant journals and newspapers in the library of Liaoning University of Traditional Chinese Medicine.After the Meta were extracted,Revman5.3 software was used for meta-analysis of included articles,quantitative system evaluation.For Meta-analysis,heterogeneity test should be conducted firstly,and only when there is homogeneity among multiple studies can the meta-analysis be conducted and the results be presented with forest map.If there is heterogeneity among multiple studies,the reasons leading to heterogeneity should be analyzed firstly,for example,control design.The heterogeneity caused by different control factors can be calculated using subgroup analysis.If there is still heterogeneity after subgroup analysis,the fixed-effect model will be replaced by random-effect model.If there is still heterogeneity,the meta-analysis will not be conducted but only the qualitative analysis,qualitative system evaluation.Results:A total of 251 articles were retrieved,and finally 13 articles meeting the inclusion criteria,all of which were Chinese articles.A total of 1654 patients were included in the PP analysis and 1708 patients were included in the ITT analysis.System evaluation results show that:1.Acupoint selection group along meridian and other meridian:(1)During the course of treatment,there was no significant difference in the safety of acupuncture between the acupoint selection group along meridian and other meridian groups,RD=0.00,95%CI=[-0.02,0.02],I~2=0%,P=0.99;(2)Within the course of treatment,the acupoint selection group along meridians was superior to other acupoint selection groups in reducing the attack times of angina pectoris.In PP analysis,MD=-1.85,95%CI=[-2.68,-1.02],I~2=0%,P<0.0001;MD=-1.74,95%CI=[-2.57,-0.92],I~2=0%,P<0.0001 in ITT analysis;(3)During the course of treatment,the acupoint selection group along meridians was superior to the other acupoint selection group in maintaining the stable state of angina pectoris,improving the onset of angina,the results of the six-minute walk test,and the treatment satisfaction,P?0.05;(4)During the course of treatment,the acupoint selection group along meridians had no significant difference from the acupoint selection group along meridians in relieving pain due to angina pectoris,improving physical activity limitation,anxiety self-rating scale score,depression self-rating scale score,disease cognition,and nitroglycerin consumption,P>0.05.2.Acupoint selection group along meridian and non-meridian non-acupoint group:(1)During the course of treatment,there was no significant difference in the safety of acupuncture between the acupoint selection group along meridian and non-meridian non-acupoint group,RD=-0.01,95%CI=[-0.04,0.01],I~2=0%,P=0.36;(2)During the course of treatment,the acupoint selection group along meridians was superior to the non-meridian acupoint group in reducing the attack times of angina pectoris.In the PP analysis,MD=-3.46,95%CI=[-3.61,-3.31],I~2=0%,P<0.00001.MD=-3.45,95%CI=[-3.60,-3.30],I~2=0%,P<0.00001 in ITT analysis;(3)During the course of treatment,the acupoint selection group along meridians was superior to the non-acupoint group in alleviating pain due to angina pectoris,maintaining a stable state of angina pectoris,improving onset of angina pectoris,enhancing treatment satisfaction,enhancing disease cognition,improving the results of the six-minute walk test,improving the self-rating anxiety scale score,improving the self-rating depression scale score,and reducing nitroglycerin consumption,P?0.05;(4)During the course of treatment,there was no significant difference in the improvement of physical activity limitation between the acupoint selection group along meridian and non-acupoint group,P>0.05.3.Acupoint selection along meridians group and waiting treatment group:(1)There was no significant statistical significance in the safety of acupuncture between the acupoint selection group along meridian and the waiting treatment group within the course of treatment,RD=-0.00,95%CI=[-0.02,0.02],I~2=0%,P=0.82;(2)Within the course of treatment,the acupoint selection group along meridians was superior to the waiting treatment group in reducing the attack times of angina pectoris.In the PP analysis,MD=-5.38,95%CI=[-5.54,-5.22],I~2=0%,P<0.00001.MD=-5.38,95%CI=[-5.54,-5.21],I~2=0%,P<0.00001 in the ITT analysis;(3)During the course of treatment,the acupoint selection group along meridians was superior to the waiting treatment group in alleviating pain due to angina,improving the degree of physical activity limitation,maintaining the stable state of angina during the course of treatment,improving the onset of angina,enhancing treatment satisfaction,enhancing disease cognition,improving the results of the six-minute walk test,improving the self-rating anxiety scale score,improving the self-rating depression scale score,and reducing the dosage of nitroglycerin,P?0.05.Conclusion:Acupoint selection along meridian for the treatment of chronic stable angina pectoris has certain advantages in clinical efficacy as compared with acupoint selection along meridian,non-meridian and acupoint selection as well as waiting for treatment,in that it can reduce the attack times of angina pectoris,alleviate the pain degree of angina pectoris,improve the degree of physical activity limitation,maintain the stable state of angina pectoris,improve the attack of angina pectoris,enhance treatment satisfaction,enhance disease cognition,improve the self-rating anxiety scale score,improve the self-rating depression scale score,improve the results of the six-minute walk test,and reduce the consumption amount of nitroglycerin.In terms of safety,acupoint selection along meridians is not different from acupoint selection along other meridians,non-meridian non-acupoint selection and waiting for treatment. |
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