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Sommaire

Spondylarthrite ankylosante : évaluation de l'acupuncture

1. Revues systématiques et méta-analyses

1.1. acupuncture générique

1.1.1. Lv 2015 (vs traitements médicamenteux) ★

Lv ZT, Zhou X, Chen AM. [Acupuncture Therapy versus Disease-modifying Antirheumatic Drugs for the Treatment of Ankylosing Spondylitis–a Meta-analysis]. Forsch Komplementmed. 2015;22(6):395-402. [190122]

Objectives We conducted a meta-analysis evaluating the efficacy and safety of acupuncture compared to disease-modifying antirheumatic drugs in patients with ankylosing spondylitis.
Methods Four databases including Pubmed, EMBASE, Cochrane library, and ISI Web of Science were searched in December 2014, taking also the reference section into account. Randomized controlled trials that aimed to assess the efficacy of acupuncture therapy were identified. The inclusion criteria for the outcome measurements were the clinical effect, ESR, occipital wall test, chest expansion, CRP and finger ground distance. Finally, six studies met these inclusion criteria. Two reviewers screened each article independently and were blinded to the findings of each other.
Results We analyzed data from 6 RCTs involving 541 participants. Acupuncture therapy could further improve the clinical effect (OR = 3.01; 95% CI, 1.48-6.13; P = 0.002) and reduce ESR level (SMD = -0.77; 95% CI, -1.46 to -0.08; P = 0.03) compared to DMARDs; a combination of acupuncture and DMARDs could further improve clinical effect (OR = 3.20, 95% CI, 1.36-7.54; P = 0.008), occipital-wall distance (SMD = -0.84; 95% CI, -1.37 to -0.31; P = 0.002), chest expansion (SMD = 0.38; 95% CI, 0.16-0.60; P = 0.0009), and finger-ground distance (SMD = -0.48; 95% CI, -0.87 to -0.09; P = 0.02) as compared to DMARDs treatment alone.
ConclusionsOur findings support that acupuncture therapy could be an option to relieve symptoms associated with AS. These results should be interpreted cautiously due to the generally poor methodological qualities of the included trials.

1.1.2. Gong 2007 ★

Gong XM, Ren K. [Acupuncture therapy in the rehabilitative treatment of ankylosing spondylitis a systematic review]. Chinese J Rehabil Med. 2007;22:537. [181461].

目的:系统评价针灸促进强直性脊柱炎的康复和减少其远期发病率的效果.方法:计算机互联网检索MEDLINE(1978-2006)、中国学术期刊全文数据库(1994-2006)、中国生物医学全文数据库(1995-2006)、Highwire 文献数据库,获取所涉及针灸治疗强直性脊柱炎的随机或半随机对照试验;而后选择符合纳入标准的临床试验,评价其方法学质量,并从中获取患者基本情况、干预措施、终点指标和结果等相关资料进行系统评价.结果:共有7个小规模的临床随机对照试验.合计555例患者符合纳入标准,但因其在试验设计、报道上存在明显缺陷,以及试验之问存存较大差异.不符合Meta分析条件,因而只能进行定性分析;结果显示针灸治疗强直性脊柱炎具有一定的疗效(P＜0.001).结论:针灸治疗强直性脊柱炎有效,但入选的7个随机对照试验规模小,质量不高,降低了这一结论的可靠性.开展高质量、内在真实性好的相关随机对照试验非常必要
Automatic translation
Objective To evaluate the promotion of acupuncture ankylosing spondylitis rehabilitation and long-term effect of reducing its incidence.
Method Computer Internet to retrieve MEDLINE (1978-2006), China Academic Journal Full-text Database (1994-2006), the full text of Chinese Biomedical Database (1995-2006), Highwire literature database, get involved in acupuncture and moxibustion treatment of ankylosing spondylitis randomized or quasi-randomized controlled trials; then select clinical trials met the inclusion criteria to evaluate methodological quality, and to obtain the basic condition of the patient, intervention and other measures, endpoints and results Info systematic evaluation.
Results A total of seven small-scale randomized controlled trials in patients with a total of 555 cases met the inclusion criteria, but because there are obvious flaws in the experimental design, reports, and test it. Q. exist large differences exist does not meet the conditions of Meta-analysis, which can only qualitative analysis; results showed that acupuncture treatment of ankylosing spondylitis have a certain effect (P <0.001).
Conclusion Acupuncture effective treatment of ankylosing spondylitis, but selected seven randomized controlled trials are small, the quality is not high, reducing the reliability of this conclusion. conduct high-quality, good internal validity relevant randomized controlled trials is necessary