不同针具在治疗腰椎间盘突出症的有效性与安全性的系统评估和网状Meta分析  

A systematic assessment and network meta-analysis of the efficacy and safety of different needles in the treatment of lumbar disc herniation

作　　者：谢景龙 于淼 胡天旭 张鹏程 王旭凯[2] XIE Jinglong;YU Miao;HU Tianxu;ZHANG Pengcheng;WANG Xukai(College of Traditional Chinese Medicine,Changchun University of Traditional Chinese Medicine,Changchun 130117,China;Bone Center,the Affiliated Hospital of Changchun University of Traditional Chinese Medicine,Changchun 130021,China)

机构地区：[1]长春中医药大学中医学院,吉林长春130117 [2]长春中医药大学附属医院骨中心,吉林长春130021

出　　处：《广州医药》2025年第4期469-485,共17页Guangzhou Medical Journal

摘　　要：目的评价现有关于干预组仅涉及不同针具针刺或联合常规针刺治疗腰椎间盘突出症系统评价的方法学质量,以比较不同针具针刺治疗腰椎间盘突出症的治疗效果。方法通过CNKI(中国知网)、万方数据库、VIP(维普)、PubMed、Web of Science等数据库以及其他相关电子资源,对诊断、治疗腰椎间盘突出症的多种针灸技术进行全面的研究。使用AMSTAR2软件,对所有参与的系统性评估结果进行地分析,并根据不同的检测结果,确定文献筛选标准。通过Revman5.4和Cochrance风险偏倚工具,以及Stata16.0的网格Meta分析,挑选了3381个满足纳入排除要求的随机对照试验。结果以Stata 16.0统计软件制作排序图可知,杵针+电针的临床有效率SUCRA=81.6%排名第一;目测类比评分显示,银质针SUCRA(用于评估疗效的指标)=95%,排名第一。结论根据现有的研究证据,杵针+电针以及银质针优于其他9种干预措施,但确切的结果仍需要大量的随机对照试验来证明。Objective To evaluate the methodological quality of the existing systematic evaluation of the intervention group involving only different needle sets of acupuncture or combined with conventional acupuncture in the treatment of lumbar disc herniation,in order to compare the therapeutic effect of different needle sets of acupuncture in the treatment of lumbar disc herniation.Methods Through CNKI,Wanfang database,VIP,Pub Med,web of science and other databases as well as other relevant resources,a variety of acupuncture techniques for the diagnosis and treatment of lumbar disc herniation were comprehensively studied.Through the use of AMSTAR2 software,all participating systematic evaluation results were effectively analyzed,and according to different test results,which literature meets the requirements were determined.Through revman5.4,Cochrane risk bias tool,and grid meta-analysis of stata16.0,3381 RCTs meeting the inclusion and exclusion requirements were selected.Results According to the ranking chart made by stata16.0 statistical software,the clinical effective rate of pestle needle+electroacupuncture ranked first with sucra=81.6%.According to the visual analogy score,the silver needle sucra=95%,ranking first.Conclusions According to the existing research evidence,pestle needle+electroacupuncture and silver needle are better than the other nine interventions,but the exact results still need a large number of randomized controlled trials to prove.

关 键 词：针刺 腰椎间盘突出症 系统评价再评价 网状Meta分析 

分 类 号：R246.9[医药卫生—针灸推拿学]