摘要:#摘要目的:客观评价针刺治疗肠易激综合征的有效性和安全性。方法:通过7个数据库(PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP database), Wanfang Database, and Chinese Biomedical Literature Database (Sinomed )检索相关的随机对照试验,这些数据被独立提取和评价。风险偏倚用the Cochrane risk of bias assessment tool进行评价;用Review Manager Software (V5.3)进行数据合成;用GRADE评价证据的质量;试验的注册号为CRD42016037769。结果:研究共纳入17个随机对照试验,包括1032个患者。研究发现在症状严重度上,针刺配合药物比假针刺配合药物有效(n=120, RR=1.29, CI=1.11-1.50, P=0.001)。而另一个试验则表明针刺配合药物与单独使用药物相比没有统计学意义(n=48, RR=1.28, CI=1.00-1.63, P=0.05)。12个试验表明针刺比药物治疗有效(n=705, RR=1.20, CI=1.09-1.32, P=0.0002)。一个试验表明针刺和药物治疗在IBS-SSS评分上没有统计学意义(n=73, SMD=-0.45, CI=-0.91-0.02)。2个试验表明针刺与药物在GSS评分上没有统计学差异(n=100, SMD=-2.41, CI=-4.07-0.75)。5个试验表明针刺比对照组在生活质量上明显改善(n=288, SMD=0.51, CI=0.17-0.86, P=0.04)。结论:被纳入的试验具有很差的方法学质量;没有确切的结论表明针刺治疗肠易激综合征的有效性。%Objective:To evaluate the effectiveness and safety of acupuncture treatment for irritable bowel syndrome (IBS). Method: Seven databases including PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP database), Wanfang Database, and Chinese Biomedical Literature Database (Sinomed) were searched to identify relevant randomized controlled trials (RCTs). The data were extracted and assessed independently. The risk of bias was assessed using the Cochrane risk of bias assessment tool. Review Manager Software (V5.3) was used for data synthesis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to grade the quality of evidence. This trial is registered with CRD42016037769. Results: Seventeen RCTs with 1032 participants were included with poor methodological quality. We found acupuncture plus drug showed superior effects to sham acupuncture plus drug on symptom severity (n=120, RR=1.29, CI=1.11-1.50, P=0.001). One trial showed no statistically significant difference between acupuncture plus drug and drug alone on symptom severity (n=48, RR=1.28, CI=1.00-1.63, P=0.05). Twelve RCTs showed that acupuncture was superior to drug therapy on symptom severity (n=705, RR=1.20, CI=1.09-1.32, P=0.0002). One RCT on IBS-SSS failed to show statistically significant difference between acupuncture and drug (n=73, SMD=-0.45, CI=-0.91-0.02). Two RCTs on global symptom score didn’t show statistically significant difference between acupuncture and drug (n=100, SMD=-2.41, CI=-4.07-0.75). Five RCTs on quality of life showed that acupuncture showed superior effects to control condition on quality of life (n=288, SMD=0.51, CI=0.17-0.86, P=0.04). Conclusion:For the included studies with poor methodological quality, no firm conclusion can be drawn regarding the effects of acupuncture for IBS.