穴位埋线治疗神经根型颈椎病系统评价

Systematic Review of Acupoint Embedding Treating for Cervical Radiculopathy

目的:系统评价穴位埋线治疗神经根型颈椎病的有效性及安全性。方法:检索穴位埋线治疗神经根型颈椎病的国内外随机对照试验。应用Cochrane协作网提供的偏倚风险评估工具进行质量评价,使用RevMan5.3和Stata 12.0软件进行Meta分析。结果:共纳入9篇文献,共1128例患者。穴位埋线较针刺和电针能更好地提高临床有效性[OR=3.85,95%CI(2.35,6.31),P<0.000,01];在改善VAS评分方面,穴位埋线优于针刺[SMD=-1.19,95%CI(-1.85,-0.53),P=0.000,4];在改善NDI指数方面,穴位埋线优于针刺[SMD=-0.61,95%CI(-1.08,-0.14),P=0.01];在改善田中靖久量表评分方面,穴位埋线优于针刺和电针[SMD=1.31,95%CI(0.89,1.73),P<0.000,01];在安全性方面,穴位埋线后出现的不良反应例数多于针刺。结论:穴位埋线可以有效地缓解神经根型颈椎病患者的疼痛,改善患者功能状况,提高临床疗效,但是安全性较针刺低。

Objective: To systematically evaluate the efficacy and safety of acupoint embedding in the treatment of cervical radiculopathy. Methods: All randomized controlled trials of acupoint embedding in the treatment of cervical spondylotic radiculopathy were retrieved by computer. The quality assessments were performed using the Cochrane risk of bias tool. Meta-analysis was carried out with RevMan 5.3 and Stata 12.0 software. Results:A total of nine articles were included and 1128 cases were studied. The results showed that acupoint embedding could improve clinical efficacy better than acupuncture and electro-acupuncture [OR =3.85, 95% CI(2.35,6.31), P <0.000,01]. In terms of improving VAS score, acupoint embedding is better than ordinary acupuncture[SMD=-1.19, 95%CI(-1.85,-0.53), P=0.000,4];in terms of improvement of NDI index, the acupoint embedding is superior to acupuncture [SMD=-0.61, 95%CI(-1.08,-0.14), P=0.01] in trems of improving Tianzhong Jingjiu scale, the acupoint embedding is superior to acupuncture and electro-acupuncture groups [SMD=1.31, 95%CI(0.89,1.73), P<0.000,01];In terms of safety, the number of adverse reactions that occur after acupoint embedding was more than that of acupuncture. Conclusion: Acupoint embedding can effectively alleviate the pain of patients with cervical radiculopathy, improve the functional status of patients and improve clinical efficacy, but the safety is lower than that of acupuncture.