非手术疗法治疗腰椎间盘突出症的循证实践指南  

Non-operative treatments for lumbar disc herniation:an evidence-based practice guideline

作　　者：葛龙 李镜 尚文茹 邢新[3] 牛军强 闵凯莉[5] 惠旭 何升华 姜宏[7] 焦锋[8] 姚嫄 董敬石 徐倩 郝国雄 冷向阳 李刚[12] 林定坤[13] 刘军[14] 马维虎[15] 莫文[16] 史晓林[17] 宋敏 王拥军[18] 王勇平[4] 姚啸生[19] 于杰[20] 詹红生[21] 朱立国[20] 谢兴文[22] 邢丹 杜亮[24] 卢卫忠[25] 郭珂[1,3] 李紫珺[1,3] 李秀霞 李美萱 李艳飞 张立存 赵继荣 杨克虎 GE Long;LI Jing;SHANG Wenru;XING Xin;NIU Junqiang;MIN Kaili;HUI Xu;HE Shenghua;JIANG Hong;JIAO Feng;YAO Yuan;DONG Jingshi;XU Qian;HAO Guoxiong;LENG Xiangyang;LI Gang;LIN Dingkun;LIU Jun;MA Weihu;MO Wen;SHI Xiaolin;SONG Min;WANG Yongjun;WANG Yongping;YAO Xiaosheng;YU Jie;ZHAN Hongsheng;ZHU Liguo;XIE Xingwen;XING Dan;DU Liang;LU Weizhong;GUO Ke;LI Zijun;LI Xiuxia;LI Meixuan;LI Yanfei;ZHANG Licun;ZHAO Jirong;YANG Kehu(Department of Health Policy and Management,School of Public Health,Lanzhou University,Lanzhou 730000,P.R.China;World Health Organization Collaborating Center for Guideline Implementation and Knowledge Transformation/Gansu Provincial Medical Guidelines Industry Technology Center,Lanzhou 730000,P.R.China;Evidence-Based Medicine Center,School of Basic Medical Sciences,Lanzhou University,Lanzhou 730000,P.R.China;The First Hospital of Lanzhou University,Lanzhou 730000,P.R.China;The Second Clinical Medical College of Lanzhou University,Lanzhou 730000,P.R.China;Shenzhen Hospital of Traditional Chinese Medicine,Shenzhen 518033,P.R.China;Suzhou Affiliated Hospital of Nanjing University of Chinese Medicine,Suzhou 215000,P.R.China;Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Guangzhou 510000,P.R.China;The First Clinical Medical College of Lanzhou University,Lanzhou 730000,P.R.China;Gansu University of Traditional Chinese Medicine,Lanzhou 730000,P.R.China;Changchun University of Traditional Chinese Medicine,Changchun 130000,P.R.China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250000,P.R.China;Guangzhou University of Traditional Chinese Medicine,Guangzhou 510000,P.R.China;The Second Hospital of Traditional Chinese Medicine of Guangdong Province,Guangzhou 510000,P.R.China;Ningbo Sixth Hospital,Ningbo 315000,P.R.China;Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200000,P.R.China;The Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310000,P.R.China;Shanghai Univers

机构地区：[1]兰州大学公共卫生学院卫生政策与管理学系,兰州730000 [2]世界卫生组织指南实施与知识转化合作中心/甘肃省医学指南行业技术中心,兰州730000 [3]兰州大学基础医学院循证医学中心,兰州730000 [4]兰州大学第一医院,兰州730000 [5]兰州大学第二临床医学院,兰州730000 [6]深圳市中医院,广东深圳518033 [7]南京中医药大学苏州附属医院,江苏苏州215000 [8]广州市中西医结合医院,广州510000 [9]兰州大学第一临床医学院,兰州730000 [10]甘肃中医药大学,兰州730000 [11]长春中医药大学,长春130000 [12]山东中医药大学附属医院,济南250000 [13]广州中医药大学,广州510000 [14]广东省第二中医院,广州510000 [15]宁波市第六医院,浙江宁波315000 [16]上海中医药大学附属龙华医院,上海200000 [17]浙江中医药大学附属第二医院,杭州310000 [18]上海中医药大学,上海200000 [19]辽宁中医药大学附属医院,沈阳110000 [20]中国中医科学院望京医院,北京100000 [21]上海中医药大学附属曙光医院,上海200000 [22]甘肃中医药大学附属医院,兰州730000 [23]北京大学人民医院,北京100000 [24]四川大学华西医院,成都610041 [25]重庆市中医院,重庆404100

出　　处：《中国循证医学杂志》2024年第2期125-148,共24页Chinese Journal of Evidence-based Medicine

基　　金：甘肃省科技重大项目(编号:21ZD4FA009)。

摘　　要：腰椎间盘突出症(LDH)是导致腰腿痛最常见原因之一,严重影响患者的生活质量。非手术疗法作为LDH的一线治疗方案,可缓解80%~90%LDH患者的临床症状。本指南遵循《中国制订/修订临床诊疗指南的指导原则(2022版)》和《世界卫生组织指南制定手册(2014版)》,成立指南工作组。结合文献回顾和专家调研,确定14个临床问题。通过系统的证据检索、评价与分级,形成推荐意见决策表;采用德尔菲法对初步形成的推荐意见进行专家共识,最终形成19条非手术疗法治疗LDH的推荐意见。本指南可供中西医骨科相关从业人员参考和使用。Lumbar disc herniation(LDH)is one of the most important causes of back and leg pain,which seriously affects the quality of life of patients.As the first-line treatment for LDH,non-operative treatment can relieve 80%to 90%of symptoms among the patients with LDH.This guideline followed Guidelines for the Formulation/Revision of Clinical Treatment Guidelines in China(2022 edition)and WHO handbook for guideline development(2014 edition)to set up guideline working group.This guideline identified fourteen clinical questions through the literature review and clinical experts’consensus.We drafted the recommendations after systematically searching and evaluating the evidence;delphi method was adopted for expert consensus on the preliminary recommendations,finally,19 recommendations were made to guide non-operative treatments for LDH.This guideline can provide guidance for the clinical practice of Chinese and western orthopedics practitioners.

关 键 词：腰椎间盘突出症 非手术疗法 循证实践指南 

分 类 号：R681.53[医药卫生—骨科学]