电针治疗神经根型颈椎病临床疗效Meta分析

Clinical Effect of Electrol-acupuncture Treatment of Cervical Spondylotic Radiculopathy:A Meta Analysis

目的:评价电针治疗神经根型颈椎病(CSR)的临床有效性。方法:通过计算机检索CNKI、Wangfang database、CHKD、VIP、Pub Med database及Cochrane library有关电针治疗CSR的随机对照试验(RTCs),按Cochrane协作网系统评价的方法进行评价,采用Rev Man 5.3软件进行统计分析。结果:9个关于电针治疗CSR的随机对照试验共529例病人纳入研究,Meta分析结果显示:电针组与普通针刺组对比,总有效率RR=1.08,95%CI为(1.02,1.15),Z=2.66,P=0.008<0.05;治愈率RR=1.52,95%CI(1.20,1.91),Z=2.32,P=0.0004<0.05;根据日本田中靖久颈椎病症状20分法量表评分情况[MD=2.41,95%CI(2.22,2.59),Z=25.99,P<0.00001],差异均具有统计学意义,表明电针治疗CSR的临床疗效优于普通针刺。而根据MPQ评分情况[MD=-1.79,95%CI(-3.68,0.10),Z=1.86,P=0.06>0.05],差异无统计学意义,表明在两组治疗CSR后疼痛症状改善相同。结论:本研究结果表明电针治疗CSR具有较好的临床疗效,但由于缺乏高质量文献的纳入及本研究存在敏感性不确定的因素,因此需要更多设计严格的、大样本的、多中心随机对照试验进一步验证。

Objective ： To evaluate clinical therapeutic effect of electrol-acupuncture in the treatment of cervical spondylotic radiculopathy. Methods ： Randomized controlled trials （ RTCs ） concerning electrol- acupuncture on cervical spondylotic radiculopathy were searched by CNKI, Wangfang database, CHKD, VIP, PubMed database and Cochrane library. These studies were estimated according to the Cochrane synergetic system method and were given a statistical analysis with RevMan 5.3 software. Results ： A total of 529 patients in nine researches about CSR treated by electrol-acupuncture were studied. The Meta analysis results showed that： the totally effective rate [RR=1.08,95%CI （ 1.02, 1.15 ）, Z=2.66, P=0.008〈0.05]; the curative rate [RR=1.52,95%CI （ 1.20,1.91 ）, Z=2.32, P=0.0004〈0.05 ] and Tanaka Yasuku cervical spondylosis symptoms 20 point scale[MD=2.41,95%CI （ 2.22,2.59 ）, Z=25.99, P〈0.00001], there was a significant difference between the eletrol-acupuncture group and the routine acupuncture group, which showed that eletro-acupuncture had a better effect on CSR than routine acupuncture group. But MPQ scores [MD=-1.79,95%CI （-3.68,0.10）, Z=1.86, P=0.06〉0.05], which showed that the pain symptoms improved of the two groups had the same effect on CSR. Conclusion ： This recta-analysis suggests that electrol-eupuncture has a better therapeutic efficacy on CSR. Due to the lack of high quality documents and uncertain factors of sensitivity affects the strength of results. These results still need more rigorous design, large sample, mutlicentre randomized controlled to further verification.