摘要
目的:评价推拿治疗急性腰扭伤的临床疗效和安全性。方法:计算机检索中国知网、万方数据库、中国生物医学文献数据库、维普网、PubMed数据库、Cochrane Library从建库至2018年10月收录的推拿治疗急性腰扭伤的中英文随机对照临床试验文献。由2名研究者独立进行文献筛选与数据提取。对纳入文献进行质量评价后,采用RevMan5.3软件进行Meta分析。结果:初检共检出文献788篇,筛选后最终纳入文献11篇,均为中文文献。纳入的11篇文献中8篇提及随机,均未报告分配隐藏、盲法、随访和脱落的相关信息,均报告了预设结局指标。Meta分析结果显示,推拿组治疗总有效率、治愈率均高于对照组[OR=5.47,95%CI(3.27,9.16);OR=3.78,95%CI(2.34,6.11)],治疗后腰部疼痛视觉模拟量表评分低于对照组[WMD=-2.24,95%CI(-2.36,-2.21)]。仅1篇文献提及了不良反应,且2组患者均未发生不良反应,故未进行合并分析。依次剔除文献行敏感性分析,结果无明显改变。基于治疗总有效率绘制漏斗图,图形左右不对称,提示可能存在发表偏倚。结论:推拿治疗急性腰扭伤可缓解患者腰部疼痛,疗效好,并发症少。
Objective:To evaluate the clinical curative effects and safety of TUINAfor treatment of acute lumbar sprain.Methods:All Chinese and English randomized controlled trial articles about TUINA for treatment of acute lumbar sprain included from dtabase establis hing to October 2018 were retrieved from China national knowledge internet,WanFang Database,Chinese biomedical literature database,VIP Database,PubMed Database and Cochrane Librar through computer.The articles were screened and the data were extracted independ ently by two searchers.The methodological quality of research in the articles was evaluated and a Meta-analysis was conducted by using RevMan5.3 software.Results:Seven hundred and eighty-eight articles were searched out in the initial stage.After screening,11 Chinese articles were included in the final analysis.Randomization was mentioned in 8 articles out of the 11 included articles.Presupposed outcome indicators were described and allocation concealment,blind method and information about follow-up and drop-out were undescribed in all of the included articles.The results of Meta-analysis demonstrated that total effective rate and cure rate were higher and the posttreatment low back pain visual analogue scale(VAS)scores were lower in TUINA group compared to control group(OR=5.47,95%C/(3.27,9.16);Ofl=3.78,95%C7(2.34,6.11);TFMD=-2.24,95%C7(-2.36,-2.21)).The adverse reactions were mentioned in 1 article and no adverse ractions were found in the 2 groups,so merged analysis could not be conducted.The snsitivity analysis was conducted ater exclu ding the articles in turn,and no obvious change of meta-analysis results were found.Funnel plot was drawn according to total effective rate,and the asymmetrical funnel plot demonstrated that there might be publication bias.Conclusion:TUINA can relieve the low back pain in treatment of acute lumbar sprain,and it has the advantages of better clinical curative effects and less complications.
作者
饶子龙
廖安庭
宋南昌
RAO Zilong;LIAO Anting;SONG Nanchang(Jiangxi Combinational Hospital of Traditional Chinese Medicine and Western Medicine,Nanchang 330003,Jiangxi,China;College of Acupuncture-Moxibustion and Tuina of Jiangxi University of Traditional Chinese Medicine,Nanchang 330004,Jiangxi,China)
出处
《中医正骨》
2019年第12期29-33,共5页
The Journal of Traditional Chinese Orthopedics and Traumatology
