手法治疗腰椎间盘突出症随机对照试验的Meta分析  

Meta analysis of randomized controlled trials of manual treatment of lumbar disc herniation

作　　者：申韬 陈宇奇 叶勇[3] 汤伟[3] 罗容[3] 潘江[3] 邵湘宁[3] SHEN Tao;CHEN Yu-qi;YE Yong;TANG Wei;LUO Rong;PAN Jiang;SHAO Xiang-ning(Kunshan Rehabilitation Hospital,Kunshan,Jiangsu 215300,China;Kunshan Hospital of Chinese Medicine,Kunshan,Jiangsu 215300,China;The first Hospital of Hunan University of Chinese Medicine,Changsha,Hu'nan 410007,China)

机构地区：[1]昆山市康复医院,江苏昆山215300 [2]昆山市中医医院,江苏昆山215300 [3]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《颈腰痛杂志》2023年第3期329-334,共6页The Journal of Cervicodynia and Lumbodynia

基　　金：湖南省中医药科研计划项目重点课题(编号:201907);湖南省发改委创新研发项目(编号:2019127);湖南省“十四五”第一批中医药领军人才和学科带头人培养项目(编号:湘中医药[2022]4号);昆山市中医药科技发展基金(编号:KZYY2212)。

摘　　要：目的对手法治疗腰椎间盘突出症(lumbar disc herniation,LDH)的临床疗效进行Meta分析。方法检索2009年1月1日~2019年5月31日的Cochrane library、Embase、Pubmed、中国知网、中国生物医学文献服务系统、万方数据知识服务平台、维普资讯中文期刊服务平台,查找手法治疗LDH的随机对照试验,由2位研究者独立根据改良版的Jadad量表进行质量评价,确定最终纳入文献11篇。通过Review Manage 5.3软件进行Meta分析。结果最终纳入11篇RCT,共935名患者。Meta分析显示:手法治疗LDH可以降低VAS评分[MD=-1.03,95%CI(-1.37,-0.70),P<0.00001],提高治疗有效率[RR=1.14,95%CI(1.07,1.22),P<0.0001],提高JOA评分[MD=2.85,95%CI(1.50,4.20),P<0.0001],降低ODI指数[MD=-15.91,95%CI(-25.24,-6.58),P=0.0008]。结论手法治疗LDH在疗效方面(降低VAS评分,提高治疗有效率,改善腰部功能障碍)的作用较为明确。Objective To conduct a Meta-analysis of the clinical effects of manual treatment of lumbar disc herniation(LDH).Methods Randomized controlled trials(RCTs)about manual therapy for LDH were electronically searched in Cochrane library,Embase,Pubmed,CNKI,SinoMed,WanFang Data,VIP from January 1,2009 to May 31,2019.Two researchers independently conducted quality evaluation based on the improved Jadad scale and determined that 11 articles were finally included in the literature.The modified version of Jadad scale was used for quality evaluation,and Meta-analysis was performed by Review Manage5.3 professional software.Results Eleven RCTs were included in a total of 935 patients.Meta-analysis showed that:manual treatment of LDH could reduce VAS score[MD=-1.03,95%CI(-1.37,-0.70),P<0.00001];manual treatment of LDH could improve treatment efficiency[RR=1.14,95%CI(1.07,1.22),P<0.0001];manual treatment of LDH could increase the JOA score[MD=2.85,95%CI(1.50,4.20),P<0.0001];manual treatment of LDH could reduce ODI score[MD=-15.91,95%CI(-25.24,-6.58),P=0.0008].Conclusion Manual therapy in the treatment of lumbar disc herniation has relatively clear effects,such as reduced VAS score,improved treatment efficiency,and improved waist dysfunction.

关 键 词：手法 腰椎间盘突出症 随机对照试验 META分析 

分 类 号：R681.5[医药卫生—骨科学] R244.1[医药卫生—外科学]