我国保守疗法治疗颈型颈椎病的系统评价

System evaluation of conservative therapy on neck type cervical spondylosis in our country

目的运用cochrane评价系统的方法评价当前国内保守疗法对颈型颈椎病的有效性与安全性。方法计算机检索CBM(1978—2008年9月)、CNKI(1979—2008年9月)、VIP(1989—2008年9月)3个数据库,辅以手工检索。电话访问标称随机对照试验作者证实是否真正RCT;纳入保守疗法治疗颈型颈椎病的随机对照试验并对其进行质量评价。结果所有研究有选择性偏倚、实施测量性偏倚、损耗性偏倚的高度可能性,质量等级均为"C"级。只有1个研究证明实验组的有效率优于对照组。4个研究均未出现不良反应而终止试验。结论所纳入的4个研究中,由于目前保守疗法的不统一,质量不高,诊断标准、随访时间、结果测量标准不一致,样本量较小,因此需要开展大样本、多中心、方法学规范的高质量随机对照试验进一步验证。

Objective It is to evaluate the effectivity and safety of nowaday domestic conservative therapy on neck type cervical spondylosis with cochxane evaluation system method. Methods Three databases that was CBM （1978September 2008）, CNKI （1979September 2008 ） and VIP （1989September 2008） were searched and manual retrieval was assisted. The Randomized Controlled Trials authors were interviewed to identify whether they were truly RCT with telephone. The quality of Randomized Controlled Trials in which conservative therapy on neck type cervical spondylosis was internalized was evaluated. Results All the studies existed higher possibility of selectivity bias, enforcing measurement bias and lose bias. Their quality grades were all grade C. Only one study proved that the effective rate of experimental group surpassed that of control group. All the experiments in the studies had not been terminated for untoward reaction. Conclusion The Randomized Controlled Trials of large sample, multicentre, normative methodology and high quality need to evolve and further validate because existing conservative therapy is disunity, the quality is not high, the standards of diagnosis, following up time and result measurement are disparity and the sample capacity is smaller in the four studies.