推拿手法治疗腰椎间盘突出症临床疗效Meta分析  

Clinical Efficacy of LDH Treated by Tuina: A Meta-Analysis

作　　者：李鹏飞[1,2] 张伟强[1,2] 韦佳佳[1,2] 李骥征[1,2] 赖福崇 李文豪 王琪 李具宝 LI Pengfei;ZHANG Weiqiang;WEI Jiajia;LI Jizheng;LAI Fucong;LI Wenhao;WANG Qi;LI Jubao(Yunnan University of Chinese Medicine,Kunming 650500,China;Yunnan Provincial Hospitalof Traditional Chinese Medicine,Kunming 650021,China)

机构地区：[1]云南中医学院,云南昆明650500 [2]云南省中医医院,云南昆明650021

出　　处：《针灸临床杂志》2019年第7期51-56,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家自然科学基金地区基金项目,编号:81460736;云南省科技计划面上项目,编号:2016FB141;云南省医疗卫生单位内设研究机构科研项目,编号:2016NS170、2016NS171、2016NS172

摘　　要：目的:探究推拿手法治疗腰椎间盘突出症的临床疗效及不同推拿手法时间应用的差异性。方法:检索PubMed、Embase、Web of science外文数据库及CNKI、VIP、WanFang、Chinese Biomedical等中文数据库自建库起至2018年7月1日公开发表的关于推拿手法治疗腰椎间盘突出症的临床随机对照研究(RCT)6项。由2名研究人员独立筛选文献并提取资料。采用RevMan5.3软件进行Meta分析。结果:共纳入6项研究,全部为RCT试验研究,采用随机效应模型合并加权均数差(WMD)对文献进行分析,显示无论长期(>3周)或短期(≤3周)推拿手法均可以缓解腰椎间盘突出症患者的疼痛,差异具有统计学意义(P<0.00001);从SF-36健康调查简表功能评分来看长期(>3周)推拿手法可能对于腰椎间盘突出症患者生存生活治疗改善有限(P=0.04),而对于腰椎间盘突出症患者Oswestry功能障碍指数评分的改善可能更为明显(P<0.00001)。结论:无论长期(>3周)或短期(≤3周)推拿手法均可以明显改善腰椎间盘突出症患者的疼痛症状及腰椎的功能,同时在严格把握适应症的基础上推拿手法具有安全性高、副作用少等治疗优势。Objective:To investigate the clinical efficacy of tuina in the treatment of lumbar disc herniation(LDH) and the time difference of the application of tuina manipulation. Methods:RCTs were reviewed from databases like PubMed,Embase,Web of science,CNKI,VIP,WanFang and Chinese Biomedical before July 1st,2018.Twp independent researchers screened the literatures and collected the data,software of RevMan5.3 was used to do meta-analysis. Results:Six RCTs were included in the study and were analyzed with Weight Mean Difference(WMD).It demonstrated that whether short-term(≤3weeks) or long-term(>3weeks) tuina intervention could both relieve the pain of LDH( P <0.000 01).In terms of the scores of SF-36,the long-term tuina intervention had limited improvement on lower limb function of the patients( P =0.04);however,it significantly improved the scores of Oswestry Function Disability Index( P <0.000 01). Conclusion:Whether short-time or long-time tuina intervention can both relieve the pain of LDH and improve the lumbar function,it is also a safe treatment with less side effect under the situation of strictly complying with the indications.

关 键 词：推拿 手法 腰椎间盘突出症 疼痛 功能 META分析 

分 类 号：R246.2[医药卫生—针灸推拿学]