艾灸治疗原发性骨质疏松症患者腰背疼痛有效性的系统评价  

The efficacy of moxibustion for low back pain of primary osteoporosis: a systematic review and Meta-analyses

作　　者：田阡陌 徐道明[2] 吴文忠[2] 刘兰英[2] 李邗峻 朱璐[1,2] 陈昊 刘静[2] 许华宁[2] 马天牧[1,2] 曹雅娜[2] TIAN Qianmo;XU Daoming;WU Wenzhong;LIU Lanying;LI Hanjun;ZHU Lu;CHEN Hao;LIU Jing;XU Huaning;MA Tianmu;CAO Yana(Nanjing University of Chinese Medicine,Nanjing 210046,China;ffiliated Hospital of Nanjing University of TCM,Nanjing 210029,China;Nanjing Qinhuai District Hospital of Traditional Chinese Medicine,Nanjing 210006,China)

机构地区：[1]南京中医药大学,南京210046 [2]南京中医药大学附属医院,南京210029 [3]南京市秦淮区中医医院,南京210006

出　　处：《天津中医药》2018年第9期684-690,共7页Tianjin Journal of Traditional Chinese Medicine

基　　金：南京市科学技术委员会项目(201611008);江苏省卫生计生委干部保健局项目(BJ16019);省级中医康复示范(江苏)中心建设项目(K2017ykf18)

摘　　要：[目的]系统评价艾灸对原发性骨质疏松症患者腰背痛的有效性。[方法]计算机检索中国知网(CNKI),万方数据库(Wan Fang),维普全文期刊数据库(VIP),中国生物医学文献数据库(CBM),Pub Med,Embase,Web of Science和Cochrane library等数据库,查找治疗组以艾灸为主,对照组以药物治疗原发性骨质疏松症腰背痛的随机对照试验,检索时限截至2017年12月。采用Revman 5.3软件进行Meta分析。[结果]最终纳入11篇文献,包括842例患者,文献质量评价显示文献质量偏低。Meta分析结果显示:艾灸组与药物组相比,在改善腰背痛疼痛视觉模拟评分法(VAS)评分、中医证候疗效、中医治疗有效率上,艾灸组优于药物组[(SMD=-1.99,95%CI:-2.76,-1.22,P<0.000 01),(SMD=-0.72,95%CI:-1.07,-0.36,P<0.000 1),(RR=1.15,95%CI:1.06,1.24,P=0.000 5)]。在临床疗效、改善腰椎骨密度方面与药物组相比不具有统计学意义[(RR=1.25,95%CI:0.90,1.73,P=0.18),(SMD=0.30,95%CI:-0.37,0.96,P=0.38)]。[结论]现有的研究结果表明,艾灸治疗原发性骨质疏松症腰背痛的疗效优于药物,并且可以与药物协同使用增效;在改善腰椎骨密度方面艾灸的疗效可能与药物相当。但是由于纳入文献质量偏低,仍需更高质量的随机对照试验来证实。[Objective]To evaluate the effectiveness of moxibustion for low back pain of primary osteoporosis(PO).[Methods]Clinical randomized controlled trials of moxibustion for low back pain of PO were searched from database of CNKI,Wan Fang,VIP,CBM,PubMed,Web of Science and The Cochrane library up to December 2017.Randomized controlled trials of moxibustion were compared with medicine treatment.Meta-analysis was performed using software RevMan5.3.[Results]A total of 11 studies involving 842 cases were included in the study.Meta-analysis suggested that moxibustion treatment was more effective than medicine on relieving low back pain[SMD=-1.99,95%CI(-2.76,-1.22),P<0.000 01],increasing the TCM syndrome integral[SMD=-0.72,95%CI(-1.07,-0.36),P<0.000 1]and improving the effective rate of TCM syndrome integral[RR=1.15,95%CI(1.06,1.24),P=0.000 5].Moxibustion treatment was as effective as medicine on clinical efficacy[RR=1.25,95%CI(0.90,1.73),P=0.18]and increasing the bone mineral density of lumbar spine[SMD=0.30,95%CI(-0.37,0.96),P=0.38].[Conclusion]The existing research results indicate that moxibustion is superior to medicine in the treatment for low back pain of primary osteoporosis,and it can promote the effect of medicine.The efficacy of moxibustion in improving lumbar bone mineral density is comparable to the medicine.However,because of the low quality of the research,more high-qualified clinical randomized controlled trials are still needed.

关 键 词：艾灸 原发性骨质疏松症 腰背痛 系统评价 Meta分析 

分 类 号：R681[医药卫生—骨科学]