艾灸  ; 桥本甲状腺炎  ; 系统评价  ; 荟萃分析

目的 系统评价艾灸治疗桥本甲状腺炎的疗效。方法 分别在CNKI、VIP、万方、CBM、PubMed、Medline、Embase、Cochrane Library数据库检索以艾灸为主要干预措施治疗桥本甲状腺炎的随机对照试验。检索结束后，由2位研究者独立进行文献筛选、资料提取，数据整合，并根据Cochrane手册对纳入文献进行偏倚风险评估，然后采用RevMan5.3软件进行Meta分析。结果 对文献筛选后最终纳入7个RCTs，共537名患者，艾灸治疗方法主要为隔药饼灸。分析结果显示，隔药饼灸在改善抗甲状腺球蛋白抗体（Thyroglobulin antibody，TGA）和抗甲状腺微粒抗体（Microsomal antibody，MCA）水平上优于西药治疗（P < 0.01）。在总有效率上，隔药饼灸加西药治疗的疗效并不优于单纯西药治疗；甲状腺激素水平的改善上，隔药饼灸结合西药对FT3、FT4的改善也不优于单纯西药治疗，但对于TSH水平的改善优于单纯西药治疗（P < 0.01）。结论 隔药饼灸在改善桥本甲状腺炎自身抗体水平方面较常规西药治疗有一定的优势；隔药饼灸结合西药还可明显改善TSH水平，但在总有效率及FT3、FT4的改善上与单纯西药比无优势。由于纳入文献质量的限制，现有的研究还不足以有充分的证据来证实隔药饼灸的疗效，可能还需设计严谨的大样本、高质量临床试验研究进行验证。

Moxibustion  ; Hashimoto s thyroiditis  ; Systematic review  ; Meta-analysis

Objective To evaluated the efficacy of moxibustion treatment for Hashimoto s thyroiditis (HT).Methods Databases of CNKI, VIP, WanFang, CBM, PubMed, Medline, Embase, Cochrane Library were searched for RCTs where moxibustion was the main intervention for Hashimoto s thyroiditis. After the search, two investigators independently performed literature screening, data extraction, data integration, and assessed the risk of bias of included literatures according to the Cochrane Handbook, then a meta-analysis was performed by using RevMan5.3 software.Results A total of 7 RCTs involving 537 patients were included and herb-partitioned moxibustion was the main moxibustion method. The results of meta-analysis showed that the herb-partitioned moxibustion was superior to western medicine in improving the levels of anti-thyroglobulin antibody (TGA) and anti-thyroid microsomal antibody (MCA) (P < 0.01). In terms of total effective rate, the efficacy of herb-partitioned moxibustion plus western medicine was not better than western medicine; in terms of thyroid function, the improvement of FT3 and FT4 levels by herb-partitioned moxibustion plus western medicine were also not better than western medicine, but was superior to western medicine in the improvement of TSH level (P < 0.01).Conclusion Herb-partitioned moxibustion has certain advantages in improving the autoantibody levels of HT compared with the conventional western medicine, and the combination of herb-partitioned moxibustion and western medicine can also significantly improve the TSH level compare with western medicine, but not the total effective rate and FT3, FT4 levels. Due to the limitation of quality of included studies, the existing researches are not enough to have sufficient evidence to confirm the efficacy of the herb-partitioned moxibustion, and rigorous design of large sample, high quality clinical studies are needed for further verification.