电针治疗腰椎间盘突出症的系统评价

The system evaluation of electroacupuncture for lumbar intervertebral disc herniation

目的运用循证医学方法系统评价电针治疗腰椎间盘突出症的有效性及安全性。方法以针刺、电针和腰椎间盘突出症、腰椎间盘突出、腰椎间盘膨出等为主题词,检索Cochrane腰背痛组,临床试验资料库,Cochrane补充医学资料库,Cochrane图书馆中心数据库,MEDLINE,EMBASE等英文数据库和中国生物光盘数据库(CBM)等中文数据库。手工检索20种中医杂志及有关学术会议论文汇编。鉴定的相关文章附录的参考文献作为补充检索。结果共5个电针治疗腰椎间盘突出症的临床随机对照试验符合纳入标准,均为较高质量研究。纳入人数共547人。整体功能汇总OR2.11(95%CI 1.18 to 3.76)。VAS评分汇总OR-0.70(95%CI-1.00 to-0.41)。肌电图评分汇总OR4.16(95%CI 2.68 to 5.64)。结论目前有限的纳入研究显示电针治疗腰椎间盘突出症安全,对改善疼痛、整体功能及电生理均较对照组有效,但因评价电生理的样本量较少,尚需更多高质量的研究补充。对电针治疗腰椎间盘突出症的生活质量的有效性尚需要更多的研究证实。

Objective It is to system assess the efficacy and safety of electroacupuncture on treating lumbar intervertebral disc herniation by using the method of evidence-based medicine.Methods With the searching terms including acupuncture,electroacupuncture,lumbar intervertebral disc herniation,lumbar disc herniation,lumbar intervertebral disc protrusion,et al,the trials registered of the Cochrane Back Group,the Cochrane Complementary Medicine Field,and the central database of the Cochrane Library as wall as MEDLINE,EMBASE and Chinese Biomedical CD database were searched from their date of inception onward.20 traditional Chinese medical journals and relevant academic conference proceedings have been hand-searched by now. The reference lists of identified documents were checked as the complementary search.Results 5 randomized controlled trials related to our question have been found.The total amount of participants in the trials was 547.The total OR of global function was OR2.11（95%CI 1.18 to 3.76）,the total OR of VAS was OR-0.70（95%CI-1.00 to-0.41）,and the total OR of EMG was OR 4.16（95%CI 2.68 to 5.64）.Conclusion Electroacupuncture is effective and safe on treating pain,global function and electrophysiology of lumbar intervertebral disc herniation.Because the number of researches about electrophysiology is small,more high-quality researches are needed.More evidence on validity of lumbar intervertebral disc herniation with electroacupuncture is still needed.