腰痛宁胶囊治疗腰椎间盘突出症随机对照试验系统评价与Meta分析  

Yaotongning Capsule(腰痛宁胶囊) for Lumbar Disc Herniation:A Systematic Review and Meta-analysis of Randomized Controlled Trials

作　　者：蔡鑫 唐芳 马武开 张绍琴 蒋总 樊梅 金泽旭 CAI Xin;TANG Fang;MA Wukai;ZHANG Shaoqin;JIANG Zong;FAN Mei;JIN Zexu(Guizhou University of Traditional Chinese Medicine,Guiyang,550002;The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine)

机构地区：[1]贵州中医药大学,贵州省贵阳市550002 [2]贵州中医药大学第二附属医院

出　　处：《中医杂志》2021年第17期1504-1508,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81760866)。

摘　　要：目的系统评价腰痛宁胶囊治疗腰椎间盘突出症的疗效和安全性。方法计算机检索中国知网、万方数据库、维普中文数据库、中国生物医学数据库以及PubMed、Cochrane Library等数据库,检索各数据库建库至2020年10月6日腰痛宁胶囊治疗腰椎间盘突出症的随机对照试验。采用RevMan 5.3软件进行疗效与安全性Meta分析,按照GRADE标准进行证据质量评价。结果最终纳入8项研究,共包括1088例患者。Meta分析显示,在总有效率方面,腰痛宁胶囊联合西药治疗优于单独西药治疗[RR=1.21,95%CI(1.09,1.34),P=0.0002];腰痛宁胶囊治疗优于其他中成药(腰痹通胶囊、小活络丹)治疗[RR=1.22,95%CI(1.13,1.31),P<0.00001];腰痛宁胶囊联合针刺治疗优于单独针刺治疗[RR=1.19,95%CI(1.05,1.34),P=0.007]。在降低疼痛视觉模拟评分(VAS)方面,腰痛宁胶囊联合西药治疗优于单独西药治疗[MD=-1.00,95%CI(-1.16,-0.84),P<0.00001];腰痛宁胶囊治疗优于其他中成药(腰痹通胶囊、小活络丹)治疗[MD=-0.96,95%CI(-1.20,-0.72),P<0.00001];腰痛宁胶囊联合针刺优于单独针刺治疗[MD=-1.10,95%CI(-1.42,-0.78),P<0.00001]。根据GRADE标准,总有效率、VAS疼痛评分证据质量为非常低。结论腰痛宁胶囊治疗腰椎间盘突出症具有一定疗效,可减轻疼痛,且不良反应少。但研究的质量不高,还需设计严谨的高质量、多中心随机对照试验以增加证据强度。Objective To systematically evaluate the effectiveness and safety of Yaotongning Capsule(腰痛宁胶囊)in the treatment of lumbar disc herniation(LDH).Methods Electronic databases including CNKI,Wanfang,VIP,SinoMed,PubMed and Cochrane Library were searched for randomized controlled trials(RCTs)exploring Yaotongning Capsule for LDH from the inception date till October 6 th,2020.RevMan 5.3 software was used to perform meta-analysis,and the quality of evidence was evaluated according to GRADE standards.Results Totally,eight RCTs were included involving 1088 patients.In terms of the total effectiveness rate,the results from meta-analysis favored Yaotongning Capsule in combination with western medicine than western medicine alone[risk ratio(RR)=1.21,95% confidence interval(CI)(1.09,1.34),P=0.0002],favored Yaotongning Capsule than other Chinese patent medicine[Yaobitong Capsule(腰痹通胶囊),Xiaohuoluo Elixir(小活络丹)][RR=1.22,95%CI(1.13,1.31),P<0.00001],and Yaotongning Capsule in combination with acupuncture than acupuncture alone[RR=1.19,95%CI(1.05,1.34),P=0.007].For reducing visual analogue score(VAS),Yaotongning Capsule in combination with western medicine had better effects than western medicine alone[MD=-1.00,95%CI(-1.16,-0.84),P<0.00001];Yaotongning Capsule was better than other Chinese patent medicine(Yaobitong Capsules,Xiaohuoluo Elixir)[MD=-0.96,95%CI(-1.20,-0.72),P<0.00001];Yaotongning Capsule combined with acupuncture is better than acupuncture alone[MD=-1.10,95%CI(-1.42,-0.78),P<0.00001].According to GRADE criteria,the quality of the evidence on the total effective rate and VAS were very low.Conclusion Yaotongning Capsule has certain effect on relieving pain and decreasing adverse reactions in treating LDH.However,as the quality of the researches is poor,further rigorous,high qualified,multi-center RCTs are needed to increase the strength of evidence.

关 键 词：腰椎间盘突出症 腰痛宁胶囊 随机对照试验 META分析 

分 类 号：R274.9[医药卫生—中西医结合]