针灸相关疗法治疗耳鸣效果的网状Meta分析*

作者：王 鑫1，任 冰1，宋硕毅1，吕汶鸿1，潘 宾2

单位：1.安徽中医药大学，安徽 合肥 230031； 2.安徽中医药大学第一附属医院，安徽 合肥 230031

引用：引用：王鑫，任冰，宋硕毅，吕汶鸿，潘宾.针灸相关疗法治疗耳鸣效果的网状Meta分析[J].中医药导报,2025,31(7):180-186.

DOI：10.13862/j.cn43-1446/r.2025.07.030

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摘要：目的：运用网状Meta分析方法评估不同针灸干预措施治疗耳鸣的临床疗效。方法：检索中国知网、万方数据库、维普网、Web of Science、Embase、PubMed数据库，筛选文献后将数据录入Stata 14.0软件，经分析绘制网络证据图、累积概率图、漏斗图等。结果：纳入文献27篇，治疗组涉及电针、针刺、电针+耳穴压丸、电针+穴位注射、针刺+耳穴压丸、针刺+穴位注射、温针灸、针刺+雷火灸、穴位注射等9种干预措施，患者2 040例。网状Meta分析结果显示，临床总有效率排序为穴位注射＞电针+穴位注射＞针刺+耳穴压丸＞电针+耳穴压丸＞针刺+穴位注射＞针刺+雷火灸＞温针灸＞针刺＞电针＞西药；降低耳鸣严重程度评分排序为电针+耳穴压丸＞温针灸＞针刺+雷火灸＞针刺＞常规西药；降低耳鸣残疾评分排序为温针灸＞穴位注射＞针刺+雷火灸＞针刺＞常规西药。结论：9种针灸干预措施在改善临床有效率以及降低耳鸣严重程度评分、耳鸣残疾评分方面均较常规西药显著，其中穴位注射临床有效率优于其他疗法，电针+耳穴压丸在降低耳鸣严重程度评分方面效果最优，温针灸在降低耳鸣残疾评分方面效果最优。

关键词：耳鸣；针灸；穴位注射；电针；耳穴压丸；温针灸；随机对照试验；网状Meta分析

Abstract：

Objective: To evaluate the clinical efficacy of different acupuncture interventions in treating tinnitus using network meta-analysis. Methods: Literatures were retrieved from China National Knowledge Network (CNKI), Wanfang Database, VIP Database, Web of Science, Embase, and PubMed. After screening, data were entered into Stata 14.0 software, and network evidence graphs, cumulative probability plots, funnel plots, etc., were generated through analysis. Results: A total of 27 literatures were included, involving 9 intervention measures in the treatment groups, including electroacupuncture, acupuncture, electroacupuncture + auricular pressure pill, electroacupuncture + acupoint injection, acupuncture + auricular pressure pill, acupuncture + acupoint injection, warm acupuncture, acupuncture + thunder-fire moxibustion, and acupoint injection, with 2,040 patients. The results of network meta-analysis showed that the ranking of total clinical effective rate was: acupoint injection > electroacupuncture + acupoint injection > acupuncture + auricular pressure pill > electroacupuncture + auricular pressure pill > acupuncture + acupoint injection > acupuncture + thunder-fire moxibustion > warm acupuncture > acupuncture > electroacupuncture > western medicine. The ranking of reducing tinnitus severity score was: electroacupuncture + auricular pressure pill > warm acupuncture > acupuncture + thunder-fire moxibustion > acupuncture > conventional western medicine. The ranking of reducing tinnitus handicap score was: warm acupuncture > acupoint injection > acupuncture + thunder-fire moxibustion > acupuncture > conventional western medicine. Conclusion: All 9 acupuncture interventions are significantly superior to conventional western medicine in improving total clinical effective rate, reducing tinnitus severity score, and tinnitus handicap score. Among them, acupoint injection is superior to other therapies in total clinical effective rate. The electroacupuncture + auricular pressure pill has the best effect in reducing tinnitus severity score, and warm acupuncture has the best effect in reducing tinnitus handicap score.

Key words：tinnitus; acupuncture; acupoint injection; electroacupuncture; auricular pressure pill; warm acupuncture; randomized controlled trial; network meta-analysis

发布时间：2026-01-06

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