中药蜡疗对不同证型腰椎间盘突出症患者干预效果的Meta分析  

Meta-analysis of Intervention Effect of Traditional Chinese Medicine Wax Therapy on Patients with Different Syndrome Types of Lumbar Disc Herniation

作　　者：杨鸽 黄俊衡 彭鸿 王小莉[1] YANG Ge;HUANG Jun-heng;PENG Hong;WANG Xiao-li(Medical College of Jishou University,Jishou 416000,Hunan,China;Department of Nursing,Ethnic Traditional Chinese Medicine Hospital of Xiangxi Tujia and Miao Autonomous Prefecture,Jishou 416000,Hunan,China)

机构地区：[1]吉首大学医学院,湖南吉首416000 [2]湘西土家族苗族自治州民族中医院护理部,湖南吉首416000

出　　处：《医学信息》2024年第3期33-39,共7页Journal of Medical Information

摘　　要：目的通过Meta分析评价中药蜡疗对不同证型腰椎间盘突出症患者的干预效果。方法计算机检索PubMed、The Cochrane Library、Web of Science、EMbase、中国知网、中国生物医学文献数据库(CBM)、万方和维普等国内外数据库,收集中药蜡疗应用于不同证型腰椎间盘突出症患者的随机对照试验(RCT),由2名研究人员根据纳入标准和排除标准对文献进行筛选,使用Cochrane手册质量评价标准进行质量评价,使用RevMan5.4软件对纳入文献的数据进行Meta分析。结果最终共纳入5篇文章,包括506例患者。Meta分析显示,与对照组相比,中药蜡疗可以提高腰椎间盘突出症患者JOA评分,改善腰椎功能(MD=5.34,95%CI:3.72~6.96,P<0.00001);应用中药蜡疗可以改善腰椎间盘突出症患者总体健康(MD=12.97,95%CI:2.30~23.64,P=0.02)、生理功能(MD=4.89,95%CI:1.97~7.81,P=0.001)、社会功能(MD=5.63,95%CI:5.29~5.98,P<0.00001),但对躯体疼痛(MD=5.11,95%CI:-2.36~12.58,P=0.18)、生理职能(MD=11.13,95%CI:-1.58~23.84,P=0.09)、活力(MD=9.84,95%CI:-0.47~20.15,P=0.06)的效果不明显;中药蜡疗可以降低腰椎间盘突出症患者VAS评分,缓解疼痛(MD=-0.99,95%CI:-1.85~-0.13,P=0.02);中药蜡疗对腰椎间盘突出症患者临床疗效与对照组比较,差异无统计学意义(OR=1.72,95%CI:0.83~3.55,P=0.15),但中药蜡疗可以提高气滞血瘀型腰椎间盘突出症患者的临床疗效(OR=2.92,95%CI:1.06~8.04,P=0.04),对寒湿型腰椎间盘突出症患者的临床疗效与对照组比较,差异无统计学意义(OR=0.85,95%CI:0.27~2.64,P=0.77)。结论中药蜡疗可以缓解腰椎间盘突出症患者的疼痛,提升生活质量,改善患者的腰椎功能,对于不同证型腰椎间盘突出患者临床疗效不同。Objective To evaluate the effect of traditional Chinese medicine wax therapy on patients with different syndrome types of lumbar disc herniation by Meta-analysis.Methods PubMed,The Cochrane Library,Web of Science,Embase,China National Knowledge Infrastructure(CNKI),Chinese Biomedical Literature Database(CBM),Wanfang and VIP databases were searched by computer to collect randomized controlled trials(RCTs)of traditional Chinese medicine wax therapy applied to patients with different syndromes of lumbar disc herniation.Two researchers screened the literature according to the inclusion criteria and exclusion criteria,and used the Cochrane manual quality evaluation criteria for quality evaluation.Meta-analysis was performed on the data included in the literature using Revman 5.4 software.Results Five studies involving 506 patients were included.Meta-analysis showed that compared with the control group,traditional Chinese medicine wax therapy could improve JOA score and lumbar function in patients with lumbar disc herniation[MD=5.34,95%CI:3.72 to 6.96,P<0.00001].In addition,traditional Chinese medicine wax therapy can improve the overall health(MD=12.97,95%CI:2.30 to 23.64,P=0.02),physiological function(MD=4.89,95%CI:1.97 to 7.81,P=0.001)and social function(MD=5.63,95%CI:5.29 to 5.98,P<0.00001)of patients with lumbar disc herniation.However,there was no significant effect on body pain(MD=5.11,95%CI:-2.36 to 12.58,P=0.18),role-physical(MD=11.13,95%CI:-1.58 to 23.84,P=0.09)and vitality(MD=9.84,95%CI:-0.47 to 20.15,P=0.06).Meanwhile,traditional Chinese medicine wax therapy could reduce the VAS score of patients with lumbar disc herniation and relieve pain(MD=-0.99,95%CI:-1.85 to-0.13,P=0.02).But there was no significant difference in the clinical efficacy of traditional Chinese medicine wax therapy in patients with lumbar disc herniation that compared with the control group(OR=1.72,95%CI:0.83-3.55,P=0.15).However,traditional Chinese medicine wax therapy could improve the clinical efficacy of patients with qi stagnation an

关 键 词：中药蜡疗 腰椎间盘突出症 痹症 

分 类 号：R274.34[医药卫生—中医骨伤科学]