传统针刺对腰椎间盘突出症效应影响的Meta分析  

Meta-analysis of the impact of traditional acupuncture on the effects of lumbar disc herniation

作　　者：许萌 张超 李嘉玮 陈劲松 董若愚 孙启越 陈江[1] XU Meng;ZHANG Chao;LI Jiawei(Dongzhimen Hospital Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《四川中医》2025年第4期189-202,共14页Journal of Sichuan of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:82374492)。

摘　　要：目的:评估传统针刺对腰椎间盘突出症的效应。方法:检索知网、维普、万方、CBM、PubMed、CEN-TRAL、Embase,纳入针刺或针刺结合其他常规疗法治疗腰椎间盘突出症的随机对照试验并对其进行资料提取。采用Cochrane协作网“偏倚风险”评价工具对纳入研究进行方法学质量评价。采用Review Manager 5.4及STATA 15.1进行数据统计分析。结果:纳入34组研究,3069例患者。结果显示在缓解疼痛、降低功能障碍指数的效果方面,针刺、针刺联合经皮内镜下椎间盘切除术、针刺联合神经阻滞术及针刺联合其他疗法优于安慰针刺、非甾体类药物、单纯经皮内镜下椎间盘切除术、神经阻滞术。在提高总有效率方面,除针刺联合经皮内镜下椎间盘切除术对比单纯经皮内镜下椎间盘切除术无明显差异外,其余结果均提示针刺及针刺联合治疗优于药物、安慰针刺或单纯其他疗法。结论:初步认为传统针刺可有效减轻腰椎间盘突出症患者的疼痛程度,并改善腰椎功能,提高患者的总有效率,且安全性较高。但仍需更多大样本、高质量研究进一步证实。Objective:To evaluate the effects of traditional acupuncture on lumbar disc herniation.Methods:A comprehen-sive search was conducted on the databases of CNKI,VIP,Wanfang,CBM,PubMed,CENTRAL,and Embase to identify ran-domized controlled trials(RCTs)that investigated the use of acupuncture alone or in combination with other conventional thera-pies for the treatment of lumbar disc herniation.Data extraction was performed for the included studies,and methodological quality assessment was carried out using the Cochrane Collaboration's“Risk of Bias”assessment tool.Data statistical analysis was con-ducted using Review Manager 5.4and STATA 15.1.Results:A total of 34studies involving 3069patients were included.The re-sults indicated that acupuncture,acupuncture combined with percutaneous endoscopic lumbar discectomy,acupuncture combined with nerve block,and acupuncture combined with other therapies were superior to sham acupuncture,non-steroidal anti-inflam-matory drugs,percutaneous endoscopic lumbar discectomy alone,and nerve block in terms of pain relief and reduction of the functional disability index.Regarding the overall effectiveness rate,except for no significant difference between acupuncture com-bined with percutaneous endoscopic lumbar discectomy and percutaneous endoscopic lumbar discectomy alone,the remaining re-sults suggested that acupuncture and acupuncture combined treatments were superior to medication,sham acupuncture,or other conventional therapies.Conclusion:Preliminary evidence suggests that traditional acupuncture may effectively alleviate pain,im-prove lumbar function,and enhance the overall effectiveness rate with a relatively high level of safety in patients with lumbar disc herniation.However,further confirmation is warranted through larger sample sizes and high-quality studies.

关 键 词：传统针刺 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]