中药蒸汽浴治疗腰椎间盘突出症临床疗效的Meta分析

发布时间：2018-01-13 11:58

  本文关键词：中药蒸汽浴治疗腰椎间盘突出症临床疗效的Meta分析　出处：《辽宁中医药大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 腰椎间盘突出症 中药蒸汽浴 系统评价 Meta分析

【摘要】：目的:探究中药蒸汽浴结合其他疗法治疗腰椎间盘突出症的临床疗效。方法:由2名系统评价员提取检索关键词,科学设计有效的文献检索策略,运用计算机检索从中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普数据库(VIP)和万方数字化期刊群(WF)中检索从各数据库的建库日期至2015年8月为止的文献;所纳入文献以中药蒸汽浴或中药蒸汽浴疗法为主结合其他疗法治疗腰椎间盘突出症为治疗组,以对应的其他方法治疗治疗腰椎间盘突出症为对照组的随机对照试验,确定纳入标准和排除标准,纳入符合标准的文献69篇。运用“Cochrane偏倚评价表”对纳入研究进行风险治疗评估,并运用Revman5.3软件分析收集到的数据。亚组分析是根据结合的不同外治法分组,观察指标分析根据治疗的有效率和VAS评分进行分析。此外,创建漏斗图分析潜在的发表偏倚。结果:研究共计8800名参与者参加,治疗组患者共计4613名,对照组患者共计4222名。结果表明,蒸汽浴疗法作为治疗组治疗腰椎间盘突出症的治疗有效率大于其它疗法作为对照组的治疗有效率(OR=5.19,95%Cl:4.44,6.06)。此外,本研究将蒸汽浴结合其他外治法分成了4个亚组,且治疗有效率均高于单独使用该外治法,“牵引”亚组(OR=6.73,95%CI4.84,9.37);“推拿”亚组(OR=4.36,95%CI2.86,6.66);“针刺”亚组(OR=5.19,95%CI2.46,10.97);“推拿针刺”亚组(OR=4.85,95%CI2.878.20)。观察指标VAS评分分析显示结果(WMD=-1.26,95%CI-1.37,-1.16)。漏斗图形几乎是对称的,说明偏倚风险小。结论:中药蒸汽浴疗法治疗腰椎间盘突出症的有效率优于其他疗法;亚组结果表明中药蒸汽浴分别结合“牵引”、“推拿”、“针刺”、“推拿针刺”治疗疗效优于单纯采用“牵引”、“推拿”、“针刺”、“推拿针刺”治疗;中药蒸汽浴治疗能明显降低腰椎间盘突出症患者VAS评分。同时需要提供更多大规模和高质量随机对照试验,进而与其他疗法验证比较尚能明确优劣。
[Abstract]:Objective: to explore the clinical efficacy of steam bath combined with other therapies in the treatment of lumbar disc herniation. Methods: the key words were extracted by two systematic evaluators and an effective literature retrieval strategy was designed scientifically. A computer search was carried out from CNKI, China Biomedical Literature Database (CBM). VIP (WIP) and WF (Digital Journal Group of Wanfang) were used to search the literature from the date of establishment of each database until August 2015. Included in the literature with traditional Chinese medicine steam bath or traditional Chinese medicine steam bath therapy combined with other therapies for the treatment of lumbar disc herniation as the treatment group. To treat lumbar disc herniation with corresponding other methods as the control group of randomized controlled trials, to determine the inclusion criteria and exclusion criteria. A total of 69 articles were included to meet the criteria. The risk treatment assessment of the inclusion study was conducted using the Cochrane bias Evaluation form. Revman5.3 software was used to analyze the collected data. The subgroup analysis was based on the combination of different external treatment methods, the observation indicators were analyzed according to the effective rate of treatment and the VAS score. In addition, the subgroup analysis was carried out according to the effective rate of treatment and the VAS score. Results: the study included 8,800 participants, 4613 patients in the treatment group and 4222 patients in the control group. The effective rate of steam bath therapy in treating lumbar disc herniation in treatment group was higher than that in other treatments as control group. In addition, this study divided steam bath and other external therapy into 4 subgroups, and the effective rate of treatment was higher than that of using the external therapy alone, and the "traction" subgroup was 6.73. 95 CI4.84 / 9.37; The "massage" subgroup was 4.36 ~ 95 CI 2.86 ~ 6.66; The "Acupuncture" subgroup was 5.19 ~ 95% CI 2.46 ~ 10.97%; The observation index VAS score analysis showed that WMD-1.2695 CI-1.37. The funnel pattern was almost symmetrical, indicating that the risk of bias was small. Conclusion: the effective rate of steam bath therapy for lumbar disc herniation is better than other treatments. The results of subgroup showed that the effect of steam bath combined with "traction", "massage", "acupuncture" and "massage acupuncture" was better than that of "traction", "massage", "acupuncture" and "massage acupuncture". Chinese medicine steam bath treatment can significantly reduce the VAS score of patients with lumbar disc herniation. At the same time, it needs to provide more large-scale and high-quality randomized controlled trials, and then compared with other therapies to verify the advantages and disadvantages.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9
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本文编号：1418793