独活寄生汤治疗腰椎间盘突出症随机对照试验的系统评价

Systematic Review of Randomized Controlled Trials of Duhuo Jisheng Decoction for Lumbar Disc Herniation

目的运用系统综述的方法评价独活寄生汤治疗腰椎间盘突出症的疗效和安全性。方法检索PubMed数据库、中国学术期刊全文数据库、中文科技期刊全文数据库、中国生物医学文献数据库、中文生物医学期刊数据库。纳入独活寄生汤单独使用或独活寄生汤联合牵引、针灸、推拿、拔罐、西医治疗与牵引、针灸、推拿、拔罐、西医治疗比较的随机对照试验。根据资料提取表进行资料提取,并采用Cochrane协作网的质量评价标准及其提供的软件RevMan5.1进行资料分析。结局的效应指标为临床疗效有效率、视觉模拟评分(VAS)以及不良反应。结果共纳入29篇研究涉及3179例腰椎间盘突出症患者,所有纳入的文献质量偏低。独活寄生汤单独使用,独活寄生汤联合牵引、针灸、推拿、拔罐、西医治疗与牵引、针灸、推拿、拔罐、西医治疗临床疗效有效率比较差异均有统计学意义(P<0.05);VAS评分差异均有统计学意义(P<0.05或P<0.01)。未见有明显不良反应。结论独活寄生汤单独使用或者联合其他疗法可改善腰椎间盘突出症患者临床症状,但试验研究方法学方面亟待提高。

Objective To observe the therapeutic effect and safety of Duhuo Jisheng Decoction （Pubescent Angelica and Mistletoe Decoction） for lumbar disc herniation. Methods PubMed, China National Knowledge Internet, VIP database, China Biology Medicine disc and Chinese Medical Current Contents were searched. The randomized clinical trials of Duhuo Jisheng Decoction or combined with other therapies such as traction, acupuncture, massage, cupping and western medicine treatment were included as compared with other therapies. The data was extracted according to the data extraction form and the data was analyzed with the quality evaluation criteria of the Cochrane Collaboration and software RevMan5.1. The outcome was evalua- ted according to the relief rate of clinical symptoms, analog visual scale （VAS） and adverse reactions. Results Totally 29 arti- cles and 3 179 patients were included. All included articles were of low quality. There were significant differences between other therapies and Duhuo Jisheng Decoction or combined with other therapies in the relief rates of clinical symptoms and VAS scores （P^0. 05 or P^0.01）. There was no obvious adverse reaction reported in the trials of Duhuo Jisheng Decoction. Conclusion Duhuo Jisheng Decoction or combined with other therapies could relieve the clinical symptoms for patients with lumbar disc her- niation. The experimental study methodology needs to be improved.