針刺治療乳腺結構不良的臨床療效和安全性評價_《中國循證醫學雜志》

作者：

于金娜 ¹ , 劉保延 ² , 劉志順 ¹ , 陳小燕 ³

1. 中國中醫研究院廣安門醫院針灸科,北京,1000532. 中國中醫研究院,北京,1007003. 四川大學華西醫學中心2000級七年制,成都,610041;

關鍵詞：

針刺治療乳腺結構不良/乳腺增生系統評價

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　評價各種針刺方法治療乳腺結構不良的有效性和安全性.
方法　通過電子和手工檢索兩種方式,對Cochrane圖書館、CENTRAL、MEDLINE(1996～2004)、EMBASE(1980～2004)、中國生物醫學文獻數據庫(1975～2004)、中國期刊全文數據庫(1994～2004)等中英文數據庫、相關學術會議論文匯編及文章的參考文獻進行檢索,納入評價針刺或針刺合并其他療法治療乳腺結構不良臨床療效的隨機對照試驗和半隨機對照試驗.
結果　共5篇文獻符合納入標準,其例數從78例到180例不等,共計534例.1個研究內的兩個亞組的痊愈率比較提示,針刺與乳癖消治療乳腺結構不良的痊愈率差異有統計學意義 [RR 9.00, 95%CI (2.29,35.43); RR 8.04, 95%CI (2.20,32.02)],且療效優于乳癖消;6個顯效率(包括亞組分析)的組間比較均提示,針刺與其他療法的組間差異無統計學意義.所有研究均未報道不良事件的發生情況.
結論　由于納入證據的質量太低和數量太少,針刺治療乳腺結構不良的療效尚不肯定,其有效性和安全性尚需更多高質量的RCT來驗證.

引用本文： 于金娜,劉保延,劉志順,陳小燕. 針刺治療乳腺結構不良的臨床療效和安全性評價. 中國循證醫學雜志, 2005, 05(5): 381-385. doi: 復制

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13.	Page Dl. The woman at high risk for breast cancer: importance of hyperplasia[J]. Surg Clin North Am, 1996; 76(2): 223-230.
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16.	Lv Meizhen. Clinical search of combination electro-acupuncture at Jiaji and acupuncture at Renying to treat mammary dysplasia[J]. Journal of Shandong university of TCM, 2004; 28(3): 214-216, 219.
17.	Dixon JM. Cystic disease and fibroadenoma of the breast: natural history and relation to breast cancer risk[J]. Br Med Bull, 1991; 47(2): 258-271.
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20.	Stovall, Thomas G. Clinical Manual of Gynecology[M]. 2nd ed. New York: McGraw-Hill, Inc; 1992.
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29.	Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary [J ] ? Control Clin Trials, 1996; 17(1): 1-12.
30.	Moher D, Pham B, Jones AR, Cook DJ, Jadad A, Moher M,Tugwell P, Klassen TP. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analysis[J].Lancet, 1998; 352(9128): 609-613.
31.	Juni P, Altman DG, Egger M. Systematic reviews in health care:Assessing the quality of controlled clinical trials[J ]. BM J, 2001; 323(7303): 42 -46.
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34.	Liu LJ, LiJF, Du D, Han CY, Li YG. Clinical observation of electro-acupuncture on selective date in treating mammary dysplasia [J ].Chinese Acupuncture & Moxibustion, 1996; 16 ( 4 ): 7 - 8.
35.	Gong DF, Yang HY, Li SH. Clinical observation and study: acupuncture in conjunction with medicine to treat mammary dysplasia[J]Acupuncture research, 1997; 22(4): 271 -273.
36.	Wang YH, Yang SQ, Ma GQ. Curative effect observation of Xiao jinwan combined with acupuncture at Beishu in treating mammary dysplasia[J]. Hei Long Jiang Medical Journal, 2003; 27(6): 441 -442.
37.	Lv DM, Jia GQ, Chen SW. Acupuncture combined with Chinese herbs to treat 39 patients with mammary dysplasia[J ]. Chinese Acupuncture & Moxibustion, 1996; 16(6): 5.

1. 馬麗華, 主編. 乳腺疾病比較影像診斷學[M]. 第1版. 北京: 軍事醫學科學出版社; 2003.
2. 劉麗軍,李金發,杜冬,韓晨燕,李炎高擇日電針治療乳腺增生病的臨床觀察[J]中國針灸1996;16(4):7～8.
3. 龔東方,楊海燕,李素荷針藥結合治療乳腺增生癥的臨床觀察與研究[J]針刺研究,1997;22(4):271～273.
4. 王玉慧,楊沈秋,馬國慶內服小金丸配合針刺背俞穴治療乳腺小葉增生病療效觀察[J].黑龍江醫學,2003;27(6):441～ 442.
5. 呂大鳴,賈桂芹,陳雙文針刺配合中藥治療乳腺增生39例[J]中國針灸,1996;l6(6):5.
6. James P. Fibrocystic breast disease[EB/OL]. Available from: URL: http://www.umm.edu/ency/article/000912.htm.
7. NCBI. Fibrocystic Disease of Breast[EB/OL]. Available from: URL: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=mesh&list_uids=68005348&dopt=Full.
8. Ma LH, ed. Comparision Image Diagnostics in Breast Diseasev[M]. 1st ed. Beijing: Military Medicine Science Press; 2003.
9. Berek JS. Novak’s gynecology[M]. 13th ed. Philadelphia: Lippincott Williams & Wilkins; 2002.
10. Hutter RVP. Is fibrocystic disease of the precancerous[J]? Arch Pathol Lab Med, 1986; 110(3): 171-173.
11. London SJ, Connolly JL, Schnitt SJ, Colditz. A prospective study of benigh breast disease and the risk of breast cancer[J]. JAMA, 1992; 267(7): 941-944.
12. Page DL, Dupont WD. Anatomic markers of human premalignancy and risk of breast cancer[J]. Cancer, 1990; 66(6 supplement): 1 326-1 335.
13. Page Dl. The woman at high risk for breast cancer: importance of hyperplasia[J]. Surg Clin North Am, 1996; 76(2): 223-230.
14. Simpson JF, Page Dl. Pathology of preinvasive and excellent-prognosis breast cancer[J]. Curr Opin Oncol, 1997; 9(6): 512-519.
15. Mansel RE, Harrison BJ, Melhuish J, Sheridan W, Pye JK, Pritchard G, Maddox PR, Webster DJ, Hughes LE. A randomised trial of dietary intervention with essential fatty acids in patients with categorized cysts[J]. Ann N Y Acad Sci, 1990; 586: 288-294.
16. Lv Meizhen. Clinical search of combination electro-acupuncture at Jiaji and acupuncture at Renying to treat mammary dysplasia[J]. Journal of Shandong university of TCM, 2004; 28(3): 214-216, 219.
17. Dixon JM. Cystic disease and fibroadenoma of the breast: natural history and relation to breast cancer risk[J]. Br Med Bull, 1991; 47(2): 258-271.
18. FRED. Fibrocystic Disease of Breast[EB/OL]. Available from: URL: http://fred.hmc.psu.edu/ds/retrieve/fred/meshdescriptor/D005348.
19. Maddox PR, Mansel RE. Management of breast pain and nodularit[J]. World J Surg, 1989; 13(6): 699-705.
20. Stovall, Thomas G. Clinical Manual of Gynecology[M]. 2nd ed. New York: McGraw-Hill, Inc; 1992.
21. Faiz O, Fentiman IS. Management of breast pain[J]. Int J Clin Pract, 2002; 54(4): 228-232.
22. Gateley CA, Miers M, Mansel RE, Huges LE. Drug treatments for mastalgia: 17 year experience in the Cardiff Mastalgia Clinic[J]. J R Soc Med, 1992; 85(1): 12-15.
23. Rea N, Bove F, Gentile A, Parmeggiani U. Prolactin response to thyrotropin-releasing hormone as a guideline for cyclical mastalgia[J]. Gynecol Endocrinol, 1997; 88(11): 479-487.
24. Kontostolis E, Stefanidis K, Navrozoglou I, Lolis D. Comparison of tamoxifen with danazol for treatment of cyclical mastalgia[J]. Gynecol Endocrinol, 1997; 11(6): 393-397.
25. Holland PA, Gateley CA. Drug therapy of mastalaia. What are the options[J]? Drugs, 1994; 48(5): 709-716.
26. London RS, Sundaram GS, Murphy L, Murphy L, Goldstein PJ. The effect of a-tocopherol on premenstrual symptomology a double-blind study[J]. J Am Coll Nutr, 1983; 2(2): 115-122.
27. Abraham GE, Nutritional factors in the etiology of the premenstrual tention syndromes[J]. J Reprod Med, 1983; 28(7): 446-464.
28. Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials[J]. JAMA, 1995; 273(5): 408-412.
29. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary [J ] ? Control Clin Trials, 1996; 17(1): 1-12.
30. Moher D, Pham B, Jones AR, Cook DJ, Jadad A, Moher M,Tugwell P, Klassen TP. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analysis[J].Lancet, 1998; 352(9128): 609-613.
31. Juni P, Altman DG, Egger M. Systematic reviews in health care:Assessing the quality of controlled clinical trials[J ]. BM J, 2001; 323(7303): 42 -46.
32. Kjaergard LL, Villumsen J, Gluud C. Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses[J]. Ann Intern Med, 2001; 135( 11 ): 982 -989.
33. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test [ J ] v BM J, 1997; 315 (7109): 629 -634.
34. Liu LJ, LiJF, Du D, Han CY, Li YG. Clinical observation of electro-acupuncture on selective date in treating mammary dysplasia [J ].Chinese Acupuncture & Moxibustion, 1996; 16 ( 4 ): 7 - 8.
35. Gong DF, Yang HY, Li SH. Clinical observation and study: acupuncture in conjunction with medicine to treat mammary dysplasia[J]Acupuncture research, 1997; 22(4): 271 -273.
36. Wang YH, Yang SQ, Ma GQ. Curative effect observation of Xiao jinwan combined with acupuncture at Beishu in treating mammary dysplasia[J]. Hei Long Jiang Medical Journal, 2003; 27(6): 441 -442.
37. Lv DM, Jia GQ, Chen SW. Acupuncture combined with Chinese herbs to treat 39 patients with mammary dysplasia[J ]. Chinese Acupuncture & Moxibustion, 1996; 16(6): 5.

《中國循證醫學雜志》

針刺治療乳腺結構不良的臨床療效和安全性評價

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《中國循證醫學雜志》

針刺治療乳腺結構不良的臨床療效和安全性評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料