针刀与针灸治疗颈椎病疗效比较的Meta分析

Meta-analysis of acupotomology versus acupuncture for cervical spondylopathy

背景:针刀和针灸是治疗颈椎病的常用疗法,但目前尚缺乏这两种方法治疗颈椎病疗效比较的系统评价。目的:系统评价针刀与针灸治疗颈椎病的疗效和安全性差异。方法:计算机检索中国生物医学文献数据库CBM(1978/2010)、中国知网CNKI(1979/2010)、维普数据库VIP(1989/2010)、PubMed(1966/2010)和CochraneLibrary(2010年第4期),辅以手工检索相关期刊,纳入针刀与针灸比较治疗颈椎病的随机对照试验。由2名评价者按照Cochrane系统评价员手册5.0的要求独立提取资料并交叉核对,采用RevMan5.1软件进行Meta分析。结果与结论:共纳入10个随机对照试验,包括1085例患者。Meta分析结果显示,针刀组治疗颈椎病近期和远期总有效率、治愈率均明显高于针灸组,症状积分改善情况针刀组优于针灸组,提示针刀治疗颈椎病疗效优于针灸。但文章纳入试验数有限且文献质量较低,需设计更严格的随机对照试验来进一步验证上述结论。

BACKGROUND：Though acupotomology and acupuncture are commonly used to treat cervical spondylopathy,there are no systematic reviews of randomized clinical trials on it.OBJECTIVE：To evaluate the therapeutic effect and safety of acupotomology versus acupuncture for cervical spondylopathy.METHODS：Randomized controlled trials （RCTs） of acupotomology versus acupuncture in the treatment of cervical spondylopathy were retrieved from CBM （1978 to 2010）,CNKI （1979 to 2010）,VIP （1989 to 2010）,PubMed （1966 to 2010）,and Cochrane Library （Issue 4,2010）.And some relevant journals were manually searched.Data were extracted and evaluated by two reviewers independently according to Cochrane Reviewers’ Handbook （5.0）.The Cochrane Collaboration’s RevMan 5.1 software was used for meta-analyses.RESULTS AND CONCLUSION：Totally 10 RCTs involving 1 085 cases were included.The results of meta-analyses showed that the total effect rate and cure rate both at short-term and long-term of the acupotomology for cervical spondylopathy were higher than the acupuncture,and improvement of symptom scores of the acupotomology group for cervical spondylopathy was superior than the acupuncture group.Acupotomology is superior to acupuncture in the treatment of cervical spondylopathy.However,due to low quality of included studies,rigorously designed RCTs are needed to confirm the above conclusions.