腕踝针及其联合疗法治疗神经根型颈椎病的Meta分析

A Meta-analysis on Treating Cervical Spondylotic Radiculopathy with Wrist-ankle Acupuncture and its Combination Therapy

目的:系统评价腕踝针及腕踝针联合其他疗法对神经根型颈椎病患者的临床疗效。方法:计算机检索CNKI、万方数据库、CBM、Pub Med、EMbass、Medline数据库,检索时间为建库至2018年5月。由两位研究员独立筛选文献,提取文献资料及评估偏倚风险并采用Rev Man5.3软件对数据进行分析。结果:共纳入12个RCT,总样本量为979例,试验组510例,对照组469例。Meta分析结果显示:10个研究显示腕踝针及联合疗法组治疗本病的有效率优于使用非腕踝针疗法组[OR=2.79,95%CI(1.87,4.16),P<0.00001],单纯腕踝针组与非腕踝针组有效率相当[OR=0.75,95%CI(0.24,2.31),P=0.62],而其联合疗法组则优于非腕踝针组[OR=3.14,95%CI(1.99,4.97),P<0.00001];8个研究显示腕踝针组及其联合疗法组对患者的VAS评分水平改善均优于非腕踝针组[WMD=-1.06,95%CI(-1.69-0.43),P=0.001]。结论:腕踝针及其联合疗法在治疗本病的临床有效率与缓解疼痛方面较非腕踝针疗法具有优势性。但受限于所纳入文献质量普遍不高、数量较少等因素,本研究结论可能存在偏倚,还需将来开展更多高质量的随机对照双盲试验予以验证。

Objective： To evaluate the clinical efficacy of treating cervical spondylotic radiculopathy with wrist-acupuncture therapy and its combination therapy. Methods： CNKI,WANGANG,CBM,Pub Med,EMbass,and Medline databases were retrieved. The retrieval time is from the time the database was built to May2018. Two researchers screened the literature independently,extracted literature data,assessed the risk of bias and analyzed the data by using Rev Man 5. 3 software. Results： A total of 12 RCTs were included in 979 cases,with 510 cases in the test group and 469 cases in the control group. The results of the meta-analysis showed that 10 studies indicated that the efficiency of the wrist-ankle acupuncture and its combination therapy group was higher than that of the non-wrist-ankle acupuncture group [OR = 2. 79,95% CI（ 1. 87,4. 16）,P 0.00001],and the efficiency of the simple-use-wrist-ankle acupuncture group was as good as that of the non-wrist-ankle acupuncture group [OR = 0. 75,95% CI（ 0. 24,2. 31）,P = 0. 62 ],while the efficiency of the combined therapy group was superior to that of the non-wrist-ankle acupuncture group [OR = 3. 14,95%CI（ 1. 99,4. 97）,P 0. 00001]. 8 studies indicated that the improvement of VAS scores of the wrist-ankle acupuncture group and its combination therapy group was better than that of the non-wrist-ankle acupuncture group [WMD =-1. 06,95% CI（-1. 69-0. 43）,P = 0. 001]. Conclusion： The wrist-ankle acupuncture and its combination therapy are more advantageous than the wrist-ankle acupuncture therapy in treating the disease and its clinical efficiency. However,limited by the quality and quantity of the included studies,the conclusions of this study may be biased and more high-quality researches should be done to verify it.