毫针针刺手法对腰椎间盘突出症效应影响的系统评价

Acupuncture Manipulation with Filiform Needle for Lumbar Disc Herniation:A Systematic Review

目的:评价针刺手法对腰椎间盘突出症效应的影响。方法:检索中国国家知识基础设施数据库(CNKI)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库、MEDLINE、CENTRAL、CINAHL、AMED、Embase、Psyc INFO共10个数据库,以及6个临床试验注册平台,收集比较不同针刺手法干预方式治疗腰椎间盘突出症的所有随机对照试验,并手工检索纳入研究的参考文献,由两人分别进行资料提取,最后采用Rev Man5.3版进行统计分析。结果:共检索到文献8716篇,经筛选后纳入随机对照试验文献22篇,共计病例数1890例。根据疼痛程度、总有效率、ODI功能障碍评分、JOA评分等指标的统计分析结果显示毫针针刺施手法、手法强刺激、施行特殊补泻手法治疗腰椎间盘突出症效果优于不施手法、手法弱刺激、施行平补平泻法。结论:初步认为施行一定的针刺手法有助于提高腰椎间盘突出症的疗效。但由于目前纳入研究质量和样本量偏低,证据尚不充分,尚需更多高质量的研究进一步证实。

Objective：To evaluate the effect of acupuncture manipulation on lumbar disc herniation（LDH）.Methods：All randomized controlled trials（RCTs） that studied the effect of acupuncture manipulation on LDH were collected from ten databases of CNKI,CBM,VIP,Wanfang Database,MEDLINE,CENTRAL,CINAHL,AMED,Embase,and Psyc INFO,and from six clinical registries;reference lists of all articles included were manually searched;data were extracted independently by two reviewers;and Review Manager software V.5.3 was used to do statistical analysis.Results：8716 articles were retrieved,and 22 RCTs（with a total of 1890cases） were included after screening.According to the statistical analysis of total effective rate,pain degree,score of Oswestry disability index（ODI） and score of Japanese Orthopaedic Association（JOA） in the treatment for LDH,the results showed that acupuncture applied with manipulation was better than that without manipulation;strong manipulation was better than mild manipulation;special manipulation was better than manipulation of neutral supplementation and draining method.Conclusion：It is supposed that acupuncture applied with certain manipulation is helpful to improve the therapeutic effect of LDH.Because of low quality of methodology and small sample size,the evidence is insufficient,and it still needs confirming with more high quality researches.