针刀治疗第三腰椎横突综合征的系统评价

发布时间：2018-03-08 21:16

本文选题：针刀　切入点：第三腰椎横突综合征　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：采用系统评价Meta分析的方法评价针刀治疗第三腰椎横突综合征的疗效及安全性。方法：根据本次研究的纳入以及排除标准,制定检索策略,然后计算机检索国内数据库CNKI、CNKI、维普数据库、万方会议论文数据库、以及外文数据库TheCochrane Library、PubMed数据库、OVID数据库。检索时间为1990年到2015年11月。筛选出符合研究标准的随机对照实验研究,对纳入研究的基本特征提取数据并制成excel表,并进行方法学质量评价。对研究进行结局指标的定量和定性分析。结果：(1)本研究共纳入11篇临床随机对照研究,其中治疗组干预措施都是针刀,对照组采用非针刀的疗法,包括5个封闭疗法,3个针刺疗法,2个电针疗法,1个穴位注射疗法,共纳入881例符合L-3横突综合征诊断标准的的病例。经统计纳入的实验的方法质量学评价较低。(2)Meta分析结果示：①针刀组与针刺组临床有效率比较结果[RR=1.05,95%CI(0.99,1.11)],临床治愈率[RR=1.77,95%CI(1.37,2.29)],VAS疼痛评分[WMD=-0.90,95%CI(-1.21,-0.59)],ODI评分[WMD=3.20,95%CI(1.71,4.69)]；②针刀组与封闭组临床有效率比较结果 [RR=1.04,95%CI(0.97,1.12)], 临床治愈率[RR=1.71,95%CI(1.30,2.24)],VAS疼痛评分[WMD=-0.35,95%CI(-1.16,0.45)],ODI评分[WMD=-0.39,95%CI(-6.14,5.36)];③针刀组与电针组临床有效率比较结果[RR=1.03,95%CI(0.98,1.08)],临床治愈率[RR=1.72,95%CI(0.94,3.16)],VAS疼痛评分[WMD=-1.76,95%CI(-2.30,-1.22)]；④针刀组与穴位注射组临床有效率比较结果[RR=1.11,95%CI(0.97,1.27)],临床治愈率[RR=2.70,95%CI(1.61,4.54)]。 (3)敏感性分析的结论显示Meta分析的结果较稳定。结论：从研究结果中可以得到针刀对第三腰椎横突综合征的治疗在临床有效率、临床治愈率、VAS疼痛评分、ODI评分方面是有一定优势的,但是由于证据质量不高,结果需谨慎对待。
[Abstract]:Objective: to evaluate the efficacy and safety of needle knife in the treatment of the third lumbar transverse process syndrome by Meta analysis. Methods: according to the criteria of inclusion and exclusion of this study, the retrieval strategy was formulated. Then the computer retrieves the domestic database CNKI CNKI, the Weip database, the Wanfang Conference paper database, The retrieval time is from 1990 to November 2015. Random controlled experimental studies that meet the research criteria are selected, and the data are extracted from the basic features of the study and made into excel tables, and the foreign language database, TheCochrane Library and PubMed database, are obtained from the database, and the retrieval time is from 1990 to November 2015. The quantitative and qualitative analysis of the outcome index of the study was carried out. Results the study included 11 clinical randomized controlled studies, in which the intervention measures in the treatment group were all needle-knife, while the non-needle-knife therapy was used in the control group. Including 5 blocking therapy, 3 acupuncture therapy, 2 electroacupuncture therapy, 1 acupoint injection therapy, A total of 881 patients who met the diagnostic criteria for L-3 transverse process syndrome were included. The qualitative evaluation of the statistical method included in the experiment was lower. The results of meta-analysis showed that the clinical effective rate of the needle knife group was lower than that of the acupuncture group [RRN 1.0595 CI 0.991.11], and the clinical cure rate [RR1.77% 95CIV 1.37% 2.29] VAS. Pain score [WMD-0.90 ~ 95CI-1.21- 0.59] ODI score [WMD-3.2095 CI-1.714.69] [WMD-0.395 CI-1.714.69] [WMD-0.3995 CI-6.14365], [RRN1.04c95CI0.971.12], [RRN1.7195CI1.302.24] VAS pain score [WMD-0.3595CI-1.160.45] ODI score [WMD-0.3995CI-6.14365.The clinical efficacy of the scalpel group [RRR1.031.095 CI-6.14895] was compared with that of the electroacupuncture group [RRR31.095 CI-1.160.95]. VAS pain score [WMD-1.7695 CI-2.30U -1.22] the results of comparison of the clinical effective rate between the needle-knife group and the acupoint injection group [RRRRR1.11295 CI0.971.27], the clinical cure rate [RRR2.70 ~ 95CI1.61.1.4.54]. The sensitivity analysis showed that the results of Meta analysis were relatively stable. Conclusion: from the results of the study, we can get the needle knife to the third point. The treatment of lumbar transverse process syndrome is effective in clinic. There are some advantages in clinical cure rate and VAS pain score and ODI score, but due to the poor quality of evidence, the results need to be treated with caution.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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