内热针与其他针刺疗法治疗腰痛的系统评价与Meta分析  

Internal Thermal Acupuncture Therapy for Low Back Pain:A Systematic Review and Meta-analysis

作　　者：陶林 杨锋[1,2] 张磊 李姣[1,2] Tao Lin;Yang Feng;Zhang Lei;Li Jiao(Shaanxi University of Chinese Medicine,Shaanxi,Xianyang 712000,China)

机构地区：[1]陕西中医药大学,陕西咸阳712200 [2]陕西中医药大学附属医院,陕西咸阳712000

出　　处：《中国中医急症》2021年第11期1891-1896,共6页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81973889);陕西省教育厅2019年度服务地方科学研究计划(19JC013)。

摘　　要：目的运用循证医学方法评价内热针与其他针刺疗法治疗腰痛的疗效比较,评价内热针疗法的应用价值。方法从中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、美国国家医学图书馆期刊文献检索系统(Pubmed)、中国生物医学文献服务系统(Sino Med)和万方资源数据库(Wanfang)检索了建库至2021年2月的内热针与其他针刺疗法治疗腰痛病的随机对照试验(RCT)。由2名研究人员根据纳入标准和排除标准独立对文献进行筛选、提取资料、交叉核对,并利用Cochrane系统评价手册评价文献质量并用Rev Man5.3软件制作文献质量评价图,以Stata16软件进行Meta分析。结果共采用14项研究,共计受试者1068例。Meta分析结果显示:有效率[OR=2.02,95%CI(1.47,2.57),P<0.01],视觉模拟疼痛评分(VAS)[MD=-2.08,95%CI(-2.34,-1.81),P<0.01],日本骨科协会(JOA)腰椎评分[MD=5.46,95%CI(4.63,6.29),P<0.01],腰屈曲范围(LFR)[MD=1.78,95%CI(1.04,2.52),P<0.01]。结论内热针较毫针、温针与电针疗法能够明显减轻腰部疼痛,改善腰椎功能。但本研究纳入文献质量不高,治疗效果证据较为有限,尚需更多大样本、多中心、高质量临床随机对照研究以佐证。Objective:Evidence based methods were used to evaluate the efficacy of internal thermal acupuncture for low back pain and to evaluate its application value.Methods:Randomized controlled trials(RCTs)of internal thermal acupuncture versus other acupuncture therapies for low back pain conditions from the database of CNKI,VIP,Pubmed Sinomed,and Wanfang were searched from their inception to February 2021.The literature was screened,extracted,cross checked independently by 2 researchers according to the inclusion and exclusion criteria,and the quality of the literature was evaluated using the Cochrane Handbook for systematic reviews and a graph was produced using RevMan5.3 software to perform a meta-analysis using Stata 16 software.Results:A total of 14 studies with a total of 1068 cases were used.The results of the meta-analysis were as follows:effective rate[OR=2.02,95%CI(1.47,2.57),P<0.01],visual analog scale(VAS)[MD=-2.08,95%CI(-2.34,-1.81),P<0.01],Japanese Orthopaedic Association(JOA)lumbar score[MD=5.46,95%CI(4.63,6.29),P<0.01],lumbar flexion range(LFR)[MD=1.78,95%CI(1.04,2.52),P<0.01].Conclusion:Internal thermal acupuncture is better than filiform needle,warming needle moxibustion and electro-acupuncture therapy,it can significantly reduce lumbar pain and improve lumbar function.However,the quality of the literature included in this study is not high,and the evidence of treatment effects is relatively limited,more large sample,multicenter,high-quality clinical randomized controlled studies are still needed for corroborating evidence.

关 键 词：腰痛 针刺 内热针 系统评价 META分析 

分 类 号：R68[医药卫生—骨科学]