手法治疗下腰痛临床随机对照试验的Meta分析  

Effect of manual therapy on patients with low back pain:a meta-analysis

作　　者：梁飞凡[1] 陈威烨[1] 陈博[2] 王辉昊[2] 徐勤光[2] 詹红生[1] 

机构地区：[1]上海中医药大学附属曙光医院石氏伤科医学中心,201203 [2]上海市中医药研究院骨伤科研究所

出　　处：《环球中医药》2016年第2期244-248,共5页Global Traditional Chinese Medicine

基　　金：国家自然科学基金(81473702);上海市科委重点项目(12411951400)

摘　　要：目的系统评价手法治疗下腰痛(low back pain,LBP)的临床疗效。方法计算机检索Pub Med、CBM、EMbase、The Cochrane Library、中国知网、维普和万方数据库,查找手法与其他疗法比较治疗LBP患者疗效的随机对照试验(RCT)。检索时间均从2004年至2014年5月。由两位评价员依据纳入排除标准分别独立筛选文献、提取资料和评价纳入研究的方法学质量后,通过Rev Man5.2软件进行Meta分析。结果最终纳入9个RCT,共计939例患者。Meta分析结果显示:与对照组相比,手法可以明显降低下腰痛患者疼痛视觉模拟评分[MD=-1.05,95%CI(-1.25,-0.86),P<0.00001],改善腰部功能活动障碍ODI评分[MD=-7.40,95%CI(-12.04,-2.76),P=0.002]、JOA评分[SMD=1.82,95%CI(0.50,3.13),P=0.007],差异有统计学意义。结论手法在治疗下腰痛方面具有一定的疗效和优势。由于受到纳入文献的数量和质量的限制,一定程度上影响了本研究结果的证据强度。以上结论上需更进一步展开多中心、大样本量、更高质量的临床RCT加以验证。Objective To systematically review the clinical efficacy of manual therapy on the patients with Low Back Pain（LBP）. Methods Randomized controlled trials （RCTs） focusing on manual therapy versus other treatments in treating LBP were electronically searched in PubMed, CBM ,EMbase, Cochrane Library, CNKI, VIP and WanFang Data （search timespan： 2004-2014）. Two reviewers independently screened literature according to the inclusion and exclusion criteria, and then they performed data extraction and quality assessment. The results of Meta-Analysis were generated by RevMan 5. 2 software. Results Nine RCTs involved 939 patients were included. The results of Meta-Analysis indicated that ： compared with the control group, Manual therapy significantly improved VAS score [ MD = - 1.05, 95%CI （-1.25,-0.86）,P〈0.00001], ODI score [MD=-7.40,95%CI （-12.04,-2.76）,P= 0. 002 ] , and JOA score[ SMD = 1.82,95% CI （0.50,3.13） , P = 0. 007 ]. There was significant difference between the manual therapy and control groups. Conclusion Manual therapy could improve LBP patients＇ pain intensity, lumbar function and activity. Due to limited quantity and quality of the included studies, larger scale, multieenter, higher quality clinical RCTs are needed to enhance the aforementioned conclusion.

关 键 词：手法 下腰痛 随机对照试验 META分析 

分 类 号：R244.1[医药卫生—针灸推拿学]