摘要
目的采用网状meta分析方法系统评价针刀及针刀疗法配合其他方法治疗腰椎间盘突出症(LDH)的效果。方法网络检索以下数据库:PubMed、Cochrane Library、中国期刊全文数据库(CNKI)、万方数据库、维普数据库(VIP)及中国生物医学文献数据库(CBMdisc),检索采用主题词与自由词相结合的方式进行,检索关键词:针刀、刃针、腰椎间盘突出症,检索时限为2009年1月~2019年7月。由两位研究者分别筛选文献、提取资料和评价纳入研究的偏倚风险,通过Stata 15.0、ADDIS v1.16.8、Review Manager 5.3软件进行数据分析。结果纳入41项研究,3962例患者,关系到17种干预措施。网状meta分析结果显示:临床总有效率排序靠前的10种干预措施:针刀+中药内服、针刀+手法、针刀+硬膜外注射、针刀+中药外用、针刀+针刺、中药内服、电针、针刀、手法、针刀+功能锻炼。结论针刀配合其他疗法在治疗LDH方面优于单一使用针刀疗法,针刀配合手法治疗LDH开展较好,针刀配合中药治疗LDH效果值得进一步研究。
Objective To systematically evaluate the effect of needle knife and needle knife combined with other therapies in the treatment of lumbar disc herniation(LDH)by network meta-analysis.Methods The following databases were searched online:PubMed,Cochrane Library,CNKI,Wanfang database,VIP and China biomedical literature database(CBMdisc).The search was conducted using a combination of subject words and free words.The search keywords included needle knife,sharp needle and lumbar disc herniation.The search time limit was from January 2009 to July 2019.Two investigators independently screened the literature,extracted the data and evaluated the risk of bias in the included studies.Data was analyzed using Stata 15.0,ADDIS v1.16.8 and Review Manager 5.3 software.Results A total of 41 studies with 3962 patients were included,involving 17 interventions.The results of network meta-analysis showed that the 10 ten intervention measures in the order of total clinical effective rate were as followed:needle knife plus internal administration of traditional Chinese medicine,needle knife plus manipulation,needle knife plus epidural injection,needle knife plus external use of traditional Chinese medicine,needle knife plus acupuncture,traditional Chinese medicine internal administration,electroacupuncture,needle knife,manipulation,needle knife plus functional exercise.Conclusion The effect of needle knife combined with other therapies is better than that of needle knife alone.Needle knife therapy combined with manipulation for LDH is well developed.The therapeutic effect of needle knife combined with traditional Chinese medicine on LDH deserves further study.
作者
王德祥
王世轩
WANG Dexiang;WANG Shixuan(Liaoning University of Traditional Chinese Medicine,Liaoning Province,Shenyang110034,China;the First Department of Orthopedics,the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Liaoning Province,Shenyang110034,China)
出处
《中国医药导报》
CAS
2020年第18期172-176,184,共6页
China Medical Herald
基金
辽宁省教育厅科学研究一般项目(L2015344)。
关键词
针刀
腰椎间盘突出症
网状meta分析
疗效评价
Needle knife
Lumbar disc herniation
Network meta-analysis
Efficacy evaluation
