目的 评述近20年来针灸治疗慢性萎缩性胃炎临床随机对照试验研究的现状。方法 检索Medline、Embase、Cochrane图书馆、中国知网数据库、重庆维普中文科技期刊数据库、万方知识服务平台数据库、中国生物医学文献数据库。检索时间从1997年1月1日截止至2017年12月31日。纳入以针灸疗法为主要干预手段治疗慢性萎缩性胃炎的随机对照试验。对检索到的文献进行筛选、改良的Jadad质量评分、数据信息提取与数据库的建立，提取的数据信息主要包括文献的发表数量、诊断标准、治疗方法与结果、腧穴选择与归经、治疗时间与疗程、疗效判定标准、结局指标等。结果 针灸治疗慢性萎缩性胃炎的随机对照试验的文章呈现逐年增多的趋势，诊断标准和疗效标准的使用缺乏统一和规范。治疗方法主要有两类，一类为针灸疗法配合药物治疗，一类为各种针灸疗法的单独或组合运用。单独作为干预措施使用的针灸疗法以针刺配合灸法最多见。取穴组方具有远近配穴、俞募配穴及循经配穴的特点，使用频率高的腧穴依次为足三里、中脘、胃俞、脾俞、内关等。选取的经脉以足阳明胃经、任脉、足太阴脾经及足太阳膀胱经居多；治疗疗程的各临床试验差异较大，结局指标以有效率为最多。临床试验的方法学质量普遍偏低。结论 目前针灸治疗慢性萎缩性胃炎疗效显著，但临床方案设计的诸多环节尚有欠缺，影响临床研究的可重复性和临床结论的准确性，有待在今后的临床研究中加以改进和完善。
Objective To review the current status of randomized controlled trial studies of the treatment of chronic atrophic gastritis using acupuncture and moxibustion in the past 20 years.Methods The Medline, Embas, Cochrane Library, China National Knowledge Infrastructure Database, Chongqing VIP Chinese Science and Technology Periodical Database, Wanfang Knowledge Service Platform Database, China Biology Medicine disc were retrieved from the time of January 1,1997 to December 31,2017. A randomized controlled trial of acupuncture as the main intervention for the treatment of chronic atrophic gastritis was included. The retrieved documents were screened and improved Jadad quality score, data information extraction and database establishment were performed. The data information mainly included the number of publications, diagnostic criteria, treatment methods and results, acupoint selection and menstruation, treatment time and course of treatment, efficacy judgment criteria, outcome indicators, etc.Results The articles on randomized controlled trials of acupuncture and moxibustion for chronic atrophic gastritis showed an increasing trend year by year, and the use of diagnostic criteria and efficacy standards lacks uniformity and standardization. There were 2 main treatment methods, one was acupuncture therapy combined with drug therapy, and the other was a combination of acupuncture therapy alone or in combination. The method of acting as an intervention alone was most common with acupuncture and moxibustion. Acupoint characteristics included far and near point method and Shu Mu point method. The acupoints with high frequency of use are Zusanli (ST36), Zhongwan (RN12), Weishu (BL21), Pishu (BL20), Neiguan (PC6), etc. The stomach Meridian of Foot-Yangming, Ren meridian, the spleen Meridian of Foot-Taiyin, the bladder Meridian of Foot-Taiyang were most used. The treatment course varied greatly and the outcome indicators were based on efficiency, so the methodological quality of clinical trials was generally poor.Conclusion At present, acupuncture treatment has significant effect on chronic atrophic gastritis. However, many aspects of clinical design are still defective, which affect the reproducibility of clinical studies and the accuracy of clinical conclusions. All of these need to be improved in future clinical research.