腹针治疗腰椎间盘突出症临床疗效 Meta 分析
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R681.5+3

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国家自然科学基金青年项目(81603693);浙江省中医药科技计划项目(2014ZA063)


Meta-analysis of Clinical Effect of Abdominal Acupuncture for Lumbar Disc Herniation
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    摘要:

    目的:评价腹针治疗腰椎间盘突出(LDH)的疗效和安全性。方法:检索符合纳入标准的RCT并提取纳入文献的基线资料,评价文献的风险偏倚;采用漏斗图对发表偏倚进行评估;采用RevMan 5.3软件进行Meta分析。结果:合计纳入27个RCT,Meta分析结果显示,临床疗效:腹针组治疗腰椎间盘突出总有效率与对照组比较,差异有统计学意义[OR=4.71,95%CI(3.41,6.52),P<0.000 01];进一步对单纯腹针疗法、腹针联合其他疗法进行亚组分析,合并效应量分别为[OR=4.66,95%CI(3.16,6.85),P<0.000 01]和[OR=4.85,95%CI(2.67,8.79),P<0.000 01],提示治疗组的2个亚组的临床疗效优于对照组。M-JOA评分疗效:腹针组改善M-JOA评分疗效优于对照组[MD=2.52,95%CI(0.66,4.38),P=0.008]。VAS评分疗效:其中有3个研究的单纯腹针组疗效优于对照组(P<0.05),有3个研究的单纯腹针组与对照组疗效相当(P>0.05);而腹针联合其它疗法组的疗效优于对照组(P<0.05)。结论:腹针疗法是临床治疗LDH的有效疗法,且腹针联合其它疗法时疗效更佳;但由于本次纳入研究的方法学质量参差不齐,该证据尚需更多高质量试验验证。

    Abstract:

    Objective: To evaluate the curative effect and safety of abdominal acupuncture in treating lumbar disc herniation(LDH).Methods:Retrieved randomized controued trials(RCTs)that meet the inclusion criteria and extracted baseline data included in the literature,assessed the risk bias of the literature.A funnel plot was adopted to evaluate the publication bias.RevMan 5.3 software was applied for Meta-analysis.Results:A total of 27 RCTs were included.The result of the analysis showed that, the clinical effect: compared the total effective rate of the abdominal acupuncture group and the control group in treating lumbar disc herniation,difference being significant[OR=4.71,95%CI(3.41,6.52),P < 0.000 01].Further analyzed the simple abdominal acupuncture therapy and abdominal acupuncture combined with other therapies in subgroups,and the combined effect amounts were respectively[OR=4.66,95%CI(3.16,6.85),P < 0.000 01]and[OR=4.85,95%CI(2.67,8.79),P < 0.000 01].The clinical effect in two subgroups of the treatment group was better than that of th e control group.Curative effect of Modify Japanese orthopedic association low back pain score(M-JOA):the curative effect of improving M-JOA score in the abdominal acupuncture group was better than that in the control group[MD=2.52,95%CI(0.66,4.38),P=0.008].Curative effect of Visual analogue scales(VAS):among those researches the curative effect of the simple abdominal acupuncture group in three researches was better than that in the control group(P < 0.05),while the curative effect of the simple abdominal acupuncture group in other three researches was equivalent to that in the control group(P< 0.05),and the curative effect in the group of abdominal acupuncture combined with other therapies was better than that in the control group(P<0.05).Conclusion:The abdominal acupuncture therapy is an effective therapy in the clinical treatment of LDH,and the curative effect in the group of abdominal acupuncture combined with other therapies is more significant.But the evidence still needs verifying by more high-quality tests due to the irregular quality of the included methodology.

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胡汉通,王超,狄忠,李邦伟,高宏.腹针治疗腰椎间盘突出症临床疗效 Meta 分析[J].新中医,2018,50(6):54-59

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  • 在线发布日期: 2018-06-05
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