补益肝肾、活血化瘀类中药复方治疗腰椎间盘突出症的Meta分析  

Meta-analysis of Buyi Ganshen and Huoxue Huayu Prescriptions in the Treatment of Lumbar Disc Herniation

作　　者：姜昆[1] 刘晴晴[1] 陶宝琛 郑斌[1] 魏成建[2] 

机构地区：[1]南京中医药大学第一临床医学院,南京210023 [2]南京中医药大学附属医院,南京210029

出　　处：《中国药房》2016年第36期5118-5122,共5页China Pharmacy

摘　　要：目的:系统评价补益肝肾、活血化瘀类中药复方治疗腰椎间盘突出症(LDH)的疗效,为临床提供循证参考。方法:计算机检索中国期刊全文数据库、中文科技期刊数据库、万方数据库、Pub Med、Springer、Medline,纳入补益肝肾、活血化瘀类中药复方(试验组)对比其他疗法(未使用补益肝肾、活血化瘀类中药复方,对照组)治疗LDH的随机对照试验(RCT)和临床对照试验(CCT),提取资料并根据改良Jadad评分量表评价纳入研究质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入39项RCT,合计3 921例患者。Meta分析结果显示,试验组患者总体有效率[OR=4.41,95%CI(3.55,5.48),P<0.001]显著高于对照组,视觉模拟疼痛(VAS)评分[MD=-1.05,95%CI(-1.49,-0.62),P<0.001]、Oswestry功能障碍指数问卷表(ODI)评分[MD=-4.36,95%CI(-8.14,-0.58),P=0.02]均显著低于对照组,差异均有统计学意义。两组患者日本骨科协会评估治疗(JOA)分数比较差异无统计学意义[MD=1.48,95%CI(-1.41,4.37),P=0.32]。结论:补益肝肾、活血化瘀类中药复方治疗LDH疗效较好,可以明显改善患者腰背部疼痛及下肢麻木、放射痛等不适症状。OBJECTIVE： To systematically review the efficacy of Buyi ganshen and Huoxue huayu prescriptions in the treatment of lumber disc hernition （LDH）, and provide evidence-based reference for clinic. METHODS ： Retrieved from CNKI, Wanfang Databse, PubMed, Springer and Medline （from Jan. 2003 to Oct. 2015）, randomized controlled trials （RCT） and clinical con- trolled trials （CCT） about the Buyi ganshen and Huoxue huayu prescriptions （test group） versus other treatment （no Buyi ganshen and Huoxue huayu prescriptions, control group） in the treatment of LDH were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by modified Jadad rating scale. RESULTS： Totally 39 studies were included, involving 3 921 patients. Results of Meta-analysis showed the total effective rate [OR=4.41,95%CI（3.55,5.48）,P〈0.001] in test group was significantly higher than control group, the score of visual analogue scale （VAS）[MD= -1.05,95 %CI（- 1.49, -0.62）, P〈0.001] and Oswestry disability index （ODI） score [MD= -4.36,95% CI （ -8.14, -0.58）, P=0.02] were significantly lower than control group, with statistical significances. There was no significant difference in the Japanese Orthopaedic Association assessment treatment （JOA） score [MD = 1.48,95 % CI （ -1.41,4.37）, P= 0.32] in 2 groups. CONCLUSIONS ： Buyi ganshen and Huoxue huayu prescriptions show good efficacy in the treatment of LDH, which can obviously improve the low back pain, numbness of the lower limbs, radition pain and other symptoms of discomfort.

关 键 词：补益肝肾 活血化瘀 中药复方 腰椎间盘突出症 META分析 疗效 

分 类 号：R274.34[医药卫生—中医骨伤科学]