浮针治疗腰椎间盘突出症临床疗效的Meta分析

发布时间：2018-11-10 18:59

【摘要】：目的:探究浮针疗法治疗腰椎间盘突出症的优越性及其相关随机对照临床试验研究的现状。方法:由2名系统评价员对关键词提取进行检索,制定的检索策略要求科学有效,计算机检索的数据库有维普中文科技期刊数据库、中国知网、中国生物医学文献数据库、万方会议论文数据库、Pubmed数据库、Cochrane Library。年限从1996年至2016年;纳入的治疗腰椎间盘突出症的治疗组全部以浮针疗法或浮针为主要疗法,治疗腰椎间盘突出症的对照组采用以针刺等其他疗法的随机对照临床试验,根据排除和纳入的标准,最终19篇文献符合纳入的标准。对纳入文献的风险治疗评估用Cochrane偏倚评价表作为标准,收集到的数据运用Revman5.3软件进行分析。根据浮针疗法结合的其他不同的外治疗法作为亚组分析,VAS评分和治疗的有效率作为观察指标分析。结果:参与本次研究共有1834名患者,均来自门诊及住院部,患者年龄范围在20~84岁之间,均符合腰椎间盘突出症的诊断标准,其中926名患者作为治疗组,908名患者为对照组。结果显示浮针疗法作为治疗组对腰椎间盘突出症治疗的临床疗效优于非浮针疗法作为对照组治疗的临床疗效(OR=3.59,95%CI:2.56,5.02)。此外,本研究将单纯浮针治疗、浮针结合针刺治疗、浮针结合牵引治疗分成了3个亚组,三组临床疗效均优于对照组。“单纯浮针”亚组(OR=4.03,95%CI:2.51,6.47);“浮针结合针刺”亚组(OR=5.07,95%CI:1.99,12.92);“浮针结合牵引”亚组(OR=2.28,95%CI:1.13,4.61)。VAS评分(WMD=-1.21,95%CI-2.17,-0.25)说明浮针在治疗腰椎间盘突出症的过程中,能够降低患者的VAS评分。漏斗图形左右对称性良好,说明本次研究的发表偏倚风险不大。结论:本研究表明浮针疗法治疗腰椎间盘突出症临床疗效优于其他疗法;亚组结果表明单纯浮针治疗、浮针结合针刺治疗、浮针结合牵引治疗疗效均优于单纯采用针刺和牵引的疗效;浮针疗法对腰椎间盘突出症患者的VAS评分有明显降低作用。浮针疗法具有潜在优势,需要更多的高质量的随机对照试验来进一步的证明。
[Abstract]:Objective: to investigate the advantages of floating acupuncture therapy in the treatment of lumbar disc herniation and the current status of randomized controlled clinical trials. Methods: the key words were retrieved by two system evaluators, and the retrieval strategy was designed to be scientific and effective. The databases of computer retrieval included Weipu Chinese Science and Technology Journal Database, China knowledge Network and Chinese Biomedical Literature Database. Wanfang conference paper database, Pubmed database, Cochrane Library. Years from 1996 to 2016; All the treatment groups involved in the treatment of lumbar disc herniation were mainly treated with floating acupuncture or floating acupuncture. The control group for treatment of lumbar disc herniation was treated with randomized controlled clinical trials of acupuncture and other therapies, according to the criteria of exclusion and inclusion. The final 19 articles met the inclusion criteria. The collected data were analyzed by Revman5.3 software using the Cochrane bias evaluation table as the standard for the risk treatment evaluation included in the literature. According to floating acupuncture therapy combined with other different external therapy as subgroup analysis, VAS score and effective rate of treatment were analyzed as observation indicators. Results: a total of 1834 patients from outpatient and inpatient departments were involved in the study. The age range of the patients was between 20 and 84 years old. All patients were in accordance with the diagnostic criteria of lumbar disc herniation. 926 patients were used as treatment group and 908 patients as control group. The results showed that the clinical effect of floating acupuncture therapy on lumbar disc herniation was better than that of non-floating acupuncture therapy on lumbar disc herniation (OR=3.59,95%CI:2.56,5.02). In addition, the treatment of floating acupuncture, floating needle combined with traction treatment was divided into three subgroups. The clinical efficacy of the three groups was better than that of the control group. "floating acupuncture" subgroup (OR=4.03,95%CI:2.51,6.47), "floating acupuncture combined with acupuncture" subgroup (OR=5.07,95%CI:1.99,12.92); The "floating needle combined traction" subgroup (OR=2.28,95%CI:1.13,4.61). VAS score) showed that floating acupuncture could reduce the VAS score in the treatment of lumbar disc herniation. The good left and right symmetry of funnel patterns indicates that the risk of publication bias in this study is not significant. Conclusion: this study shows that floating acupuncture therapy is superior to other therapies in the treatment of lumbar disc herniation. The results of subgroup showed that the effect of floating acupuncture combined with acupuncture and floating acupuncture combined with traction was better than that of simple acupuncture and traction. The VAS score of patients with lumbar intervertebral disc herniation was significantly decreased by floating acupuncture. Floating-needle therapy has potential advantages and requires more high-quality randomized controlled trials to be further demonstrated.
【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】：2017
【分类号】：R246.9

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