推拿改善椎动脉型颈椎病患者基底动脉平均血流速度的系统评价  

Efficacy of manipulation therapy in improving mean blood flow velocity of basilar artery in patients with vertebral-artery-type cervical spondylopathy: a systematic review

作　　者：张星贺 郭太品[2] 冯慧超[1] 曾豊婷 井夫杰[1] ZHANG Xinghe;GUO Taipin;FENG Huichao;ZENG Liting;JING Fujie(Shandong University of Traditional Chinese Medicine,Jinan 250355,Shandong,China;Yunnan College of Traditional Chinese Medicine,Kunming 650500,Yunnan,China)

机构地区：[1]山东中医药大学,山东济南250355 [2]云南中医学院,云南昆明650500

出　　处：《中医正骨》2018年第3期33-38,共6页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：山东省科技发展计划项目(2013G0021807);山东省高等学校科技计划项目(J12LK13)

摘　　要：目的:评价推拿改善椎动脉型颈椎病患者基底动脉平均血流速度的疗效。方法:应用计算机检索Cochrane Library、Pub Med、CNKI、Wan Fang Data、VIP建库至2017年8月收录的所有推拿治疗椎动脉型颈椎病,且评价指标中包括基底动脉平均血流速度变化量的随机对照研究文献。由2位研究者独立筛选文献、提取资料,依据Cochrane Handbook5.1.0进行文献方法学质量评价后,采用Rev Man5.3软件进行Meta分析。结果:最初共检索出3696篇文献,经筛选后最终纳入9篇文献,均为中文文献,共涉及997例患者。Meta分析结果显示,推拿与药物静脉滴注、口服药物、小针刀在改善椎动脉型颈椎病患者基底动脉平均血流速度方面比较,差异均无统计学意义[MD=0.10,95%CI(-6.56,6.76);MD=4.55,95%CI(-1.26,10.37);MD=-0.12,95%CI(-3.10,2.86)]。推拿改善椎动脉型颈椎病患者基底动脉平均血流速度的效果优于牵引和电针[MD=4.81,95%CI(1.17,8.45);MD=4.61,95%CI(2.33,6.89)]。结论:推拿改善椎动脉型颈椎病患者基底动脉平均血流速度的效果优于牵引和电针疗法,与药物治疗及小针刀治疗相比无明显优势。Objective:To evaluate the curative effect of manipulation therapy in improving mean blood flow velocity of basilar artery in patients with vertebral-artery-type cervical spondylopathy(VACS).Methods:All randomized controlled trial(RCT)articles about manipulation therapy for treatment of VACS included from database establishing to August 2 0 1 7,in which mean blood flow velocity of basilar artery was used as one of the evaluation indexes,were retrieved from Cochrane Library,Pubm ed,China national knowledge internet,WanFang Data and VIP Database of Chinese journal through computer.The articles were screened and the information was extracted independently by two searchers.The methodological quality of researches in the articles was evaluated according to Cochrane Handbook 5.1.0 and a Meta-analysis was conducted by using Rev Man 5.3 software.Results:Three thousand six hundred and ninety-six articles were searched out.After screening,9 Chinese articles(997 patients)were included in the final analysis.The results of Meta-analysis demonstrated that there was no statistical difference in improving mean blood flow velocity of basilar artery between manipulation and intravenous drug injection,between manipulation and oral application of drugs and between manipulation and small-needle-knife therapy in patients with VACS(MZ)=0.10,95%CI(-6.56,6.76);MZ>=4.5 5,9 5%C/(-1.26,10.37);MZ>=-0.1 2,9 5%C/(-3.10,2.8 6)).The curative effect of manipulation is better than that of cervical traction and electroacupuncture in improving mean blood flow velocity of basilar artery in patients with VACS(MZ>=4.8 1,9 5%C/(1.17,8.4 5);MD=4.6 1,9 5%C/(2.3 3,6.8 9)).Conclusion:Manipulation therapy is superior to cervical traction and electroacupuncture and has no obvious superiority over drug therapy and small-needle-knife therapy in improving mean blood flow velocity of basilar artery in patients with VACS.

关 键 词：推拿 脊柱 颈椎病 基底动脉 血流速度 Meta分析 系统评价 

分 类 号：R244.1[医药卫生—针灸推拿学]