抗阻运动对神经根型颈椎病患者疼痛和功能影响的荟萃分析  

Effects of resistance exercise therapy on pain and function in patients with cervical spondylotic radiculopathy:a meta-analysis

作　　者：李涵玥 李旖旎 向林妹 李森 Li Hanyue;Li Yini;Xiang Linmei;Li Sen(College of Physical Education,Southwest Medical University,Luzhou 646000,Sichuan Province,China;Department of Ultrasound,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Department of Dermatology,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Nanjing Drum Tower Hospital,Nanjing University Medical School,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]西南医科大学体育学院,四川省泸州市646000 [2]西南医科大学附属医院超声科,四川省泸州市646000 [3]西南医科大学附属医院皮肤科,四川省泸州市646000 [4]南京大学医学院附属鼓楼医院,江苏省南京市210000

出　　处：《中国组织工程研究》2026年第4期987-996,共10页Chinese Journal of Tissue Engineering Research

基　　金：四川省科技计划项目(2022NSFSC0688),项目负责人:李森;西南医科大学应用基础研究项目(2021ZKMS050),项目负责人:李森。

摘　　要：目的:近年来,抗阻运动作为一种康复治疗手段备受关注,但它对神经根型颈椎病的治疗效果仍存在一定的争议,因此有必要通过Meta分析方法评价抗阻运动治疗神经根型颈椎病的临床疗效。方法:全面检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library以及Embase文献数据库中有关抗阻运动治疗神经根型颈椎病的随机对照试验,检索时限从各数据库建库至2024-11-30,抗阻运动组(试验组)使用抗阻运动或以抗阻运动为主要干预方式;对照组为除抗阻运动的其他康复治疗。结局指标包括总有效率、目测类比评分、颈椎功能障碍指数、田中靖久颈椎病症状量表评分、颈椎关节活动度以及复发率。采用Cochrane偏倚风险评估工具和物理治疗证据数据库量表确定纳入文献质量,使用Review Manager 5.4.0软件和Stata 17.0进行Meta分析。结果:(1)最终纳入9篇随机对照试验,纳入样本量673例,GRADE证据质量评价显示,总有效率为中等证据等级,目测类比评分、颈椎功能障碍指数、田中靖久颈椎病症状量表评分、关节活动度以及复发率为低证据等级;(2)Meta分析结果显示:试验组总有效率高于对照组(RR=1.22,95%CI=1.06-1.41,P=0.005);(3)试验组目测类比评分优于对照组(MD=-0.72,95%CI=-0.98至-0.46,P<0.000 01);试验组颈椎功能残障指数优于对照组(MD=-2.57,95%CI=-4.13至-1.02,P=0.001);试验组田中靖久颈椎病症状量表评分优于对照组(MD=3.83,95%CI=3.55-4.10,P<0.000 01);试验组颈椎前屈关节活动度优于对照组(MD=2.86,95%CI=2.30-3.43,P<0.000 01);试验组颈椎后伸关节活动度优于对照组(MD=5.23,95%CI=3.81-6.64,P<0.000 01);试验组颈椎左旋转关节活动度优于对照组(MD=7.15,95%CI=5.43-8.87,P<0.000 01);试验组颈椎右旋转关节活动度优于对照组(MD=5.45,95%CI=3.59-7.31,P<0.000 01);试验组颈椎左侧屈关节活动度优于对照组(MD=3.35,95%CI=1.98-OBJECTIVE:In recent years,resistance exercise therapy as a means of rehabilitation has attracted much attention,but its therapeutic effect on cervical radiculopathy is still controversial.This study evaluated the clinical efficacy of resistance exercise in the treatment of cervical radiculopathy through a systematic meta-analysis.METHODS:A comprehensive search was conducted in CNKI,VIP,WanFang,Chinese Biomedical Literature Database,PubMed,Web of Science,Cochrane Library and Embase for clinical randomized controlled trials related to resistance exercise in the treatment of cervical radiculopathy.The search time was from the establishment of each database to November 30,2024.The resistance training group(experimental group)used resistance exercise or resistance exercise as the main intervention method.The control group received other rehabilitation therapy except resistance exercise.Outcome measures included total effective rate,visual analog scale score,Neck Disability Index,Tanaka Symptom Scale for Cervical Spondylosis,cervical joint motion,and recurrence rate.Cochrane bias risk assessment tool and physical therapy evidence database scale were used to determine the quality of the included references.Meta-analysis was performed using RevMan 5.4 software and Stata 17.0.RESULTS:(1)Finally,9 RCTs were included,including a sample size of 673 cases.GRADE evidence quality evaluation showed that the total effective rate was medium level of evidence,while visual analog scale score,Neck Disability Index,Tanaka Symptom Scale for Cervical Spondylosis score,joint motion,and recurrence rate were low level of evidence.(2)The results of meta-analysis showed that the total effective rate in the experimental group was higher than that in the control group(RR=1.22,95%confidence interval[CI]=1.06-1.41,P=0.005).(3)The visual analog scale score in the experimental group was better than that in the control group(mean difference[MD]=-0.72,95%CI=-0.98 to-0.46,P<0.00001).The Neck Disability Index in the experimental group was better than

关 键 词：抗阻运动 神经根型颈椎病 荟萃分析 运动疗法 疼痛 颈椎功能 肌肉力量 随机对照试验 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R681.55