刮痧治疗原发性痛经疗效的Meta分析

Meta-Analysis of the Efficacy of Scraping (Gua Sha) Therapy for Primary Dysmenorrhea

摘要: 目的：系统评价刮痧疗法在原发性痛经(PD)患者中的应用效果，以期为临床实践提供循证医学证据。方法：计算机检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库、维普数据库、PubMed、Embase、Web of Science、Cochrane Library等数据库，检索时限为建库至2025年3月。筛选出刮痧对比其他干预治疗PD的随机对照试验(RCT)，由2名研究者独立筛选文献、提取资料后，纳入文献的方法学质量采用Cochrane偏倚风险评估工具进行评价，采用RevMan 5.4软件进行统计分析。结果：共纳入文献9篇，总计805例原发性痛经患者。Meta分析结果显示，实验组总有效率与对照组比较，差异有统计学意义[RR = 2.67, 95%CI (1.83, 3.91), P < 0.00001]。两组在视觉模拟疼痛评分和痛经症状量表评分上存在异质性，实验组评分显著低于对照组并且差异有统计学意义(P = 0.00001)。结论：刮痧治疗PD的疗效明显优于其他组，刮痧能够有效提高PD临床疗效，改善患者腹痛程度和痛经症状。现有证据初步表明，刮痧可能对PD有效，但鉴于纳入研究普遍存在较高的偏倚风险和显著的异质性，该结论尚需未来设计严谨、样本量充足的高质量随机对照试验来证实。

Abstract: Objective: To systematically evaluate the effect of scraping therapy in patients with primary dysmenorrhea (PD), in order to provide evidence-based medical evidence for clinical practice. Methods: China Biology Medicine literature database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database, PubMed, Embase, Web of Science, Cochrane Library and other databases were searched by computer. The search time was from the establishment of the database to March 2025. The randomized controlled trials (RCTS) of scraping versus other interventions in the treatment of PD were searched. After two researchers independently screened the literature and extracted the data, the methodological quality of the included literature was evaluated by the Cochrane bias risk assessment tool, and RevMan 5.4 software was used for statistical analysis. Results: A total of 9 studies involving 805 patients with primary dysmenorrhea were included. The Meta-analysis showed that the total effective rate of the experimental group was significantly higher than that of the control group, and the difference was statistically significant [RR = 2.67, 95%CI (1.83, 3.91), P < 0.00001]. There was heterogeneity in visual analogue scale and dysmenorrhea symptom scale scores between the two groups, and the scores of the experimental group were significantly lower than those of the control group, and the difference was statistically significant (P = 0.00001). Conclusions: The efficacy of scraping in the treatment of PD is significantly better than that of other groups. Scraping can effectively improve the clinical efficacy of PD, improve the degree of abdominal pain and dysmenorrhea symptoms of patients. The existing evidence initially shows that scraping may be effective for PD, but in light of the high risk of bias and significant heterogeneity of the included studies, further high-quality randomized controlled trials with rigorous design and sufficient sample size are needed to confirm this conclusion.