针灸治疗下腰痛疗效的Meta分析  

Effect of acupuncture therapy on patients with low back pain:a Meta-analysis

作　　者：梁飞凡[1] 陈威烨[1] 陈博[1] 王辉昊[1] 徐勤光[1] 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,上海市中医药研究院骨伤科研究所,上海201203

出　　处：《中国骨伤》2016年第5期449-455,共7页China Journal of Orthopaedics and Traumatology

基　　金：国家自然基金资助项目(编号:81473702,81001528);“中医骨伤科学”国家重点学科(编号:100508);上海领军人才项目(编号:041);上海市科委重点项目(编号:12411951400);上海高校“中医脊柱病损研究”创新团队建设项目(编号:2009-26)~~

摘　　要：目的 :对针灸治疗下腰痛(LBP)的临床疗效进行Meta分析。方法 :计算机检索2004年1月至2014年5月Pub Med、EMbase、The Cochrane Library、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普(VIP)和万方数据库(Wanfang Data),查找针灸与其他疗法比较治疗LBP患者疗效的随机对照试验(RCT),由2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 Man 5.2软件对治疗前后VAS、ODI、JOA、RMDQ等评分变化进行Meta分析。结果 :最终纳入10个RCT,共计751例患者。Meta分析结果显示:单纯针灸治疗组VAS评分改善优于非针灸治疗组[RR=-1.32;95%CI(-1.41,-1.22);Z=27.28;P<0.000 01];单纯针灸治疗组ODI评分改善优于非针灸治疗组[RR=-5.07;95%CI(-7.50,-2.65);Z=4.10;P<0.000 1];单纯针灸治疗组JOA评分改善优于非针灸治疗组[RR=2.83;95%CI(2.02,3.63);Z=6.90;P<0.000 01];单纯针灸治疗组RMDQ评分改善优于非针灸治疗组[RR=-2.80;95%CI(-3.49,-2.11);Z=7.95;P<0.000 01]。结论:单纯针灸疗法在改善下腰痛患者疼痛症状和腰部功能障碍方面具有一定的疗效和优势。Objective：To systematically review the clinical efficacy of acupuncture on the patients with low back pain（LBP）. Methods：Randomized controlled trials（RCTs） about pure acupuncture therapy versus other treatments in treating LBP were electronically searched in Pub Med,CBM,EMbase,The Cochrane Library,CNKI,VIP and Wanfang Data from January 2004 to May 2014. The observed index on the results were the changed scores of VAS,ODI,JOA and RMDQ. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria,as well as the extracted data,and assessed the methodological quality. The results of Meta analysis was conducted by Rev Man 5.2 software. Results：Ten RCTs involved 751 patients were finally included. The results of Meta analysis indicated that the role of pure acupuncture group in improving the VAS score was better than that of the control group,and the combined effect size was RR=-1.32,95%CI（-1.41,-1.22）; Z=27.28,P〈0.000 01;the role of pure acupuncture group in improving the ODI score was better than that of the control group,and the combined effect size was RR=-5.07,95%CI（-7.50,-2.65）;Z=4.10,P〈0.000 1;the role of pure acupuncture group on improved JOA score was better than that of the control group and the combined effect size was RR=2.83, 95%CI（2.02,3.63）,Z=6.90,P〈0.000 01. The role of pure acupuncture group in improving the RMDQ score was better than that of the control group,and the combined effect size was RR=-2.80,95%CI（-3.49,-2.11）,Z=7.95,P〈0.000 01. Conclusion：The result of meta-analysis demonstrates that pure acupuncture may have a favorable effect on self reported pain and functional limitations in LBP patients.

关 键 词：针刺穴位 腰痛 随机对照试验 META分析 

分 类 号：R195.1[医药卫生—卫生统计学]