小针刀治疗腰椎间盘突出症疗效的Meta分析

Curative effect of small-needle-knife therapy on lumbar disc herniation: A Meta-analysis

目的:系统评价小针刀治疗腰椎间盘突出症疗效。方法:计算机检索CNKI、万方、维普数据库,查找小针刀治疗腰椎间盘突出症的随机对照试验(RCT)。由两位研究者检索筛选文献、提取相关资料、评价纳入原始研究的偏倚风险,采用Rev Man 5. 2. 5软件进行Meta分析。结果:共纳入8个RCT,1087例患者。Meta分析结果显示:只应用小针刀治疗或者小针刀联合其他疗法较不含针刀疗法治疗腰椎间盘突出症疗效差别有统计学意义[OR=4. 17,95%CI (2. 68-4. 68),P <0. 00001]。将治疗方法分为只应用小针刀及小针刀联合其他疗法两个亚组进行分析显示:只应用针刀治疗与针刀联合其他疗法疗效差异无统计学意义[χ~2=0. 08,df=1,p=0. 78]。结论:只应用小针刀治疗或者小针刀联合其他疗法较不含针刀疗法临床总有效率高,单一使用针刀治疗与针刀联合其他疗法疗效差异无统计学意义,但受本研究纳入原始研究的质量和数量限制,结论尚需要更多高质量、大样本的随机对照试验以进一步验证。

Objective To systematically evaluate the curative effect of small-needle-knife therapy on lumbar disc herniation.Methods Data of randomized controlled trials（ RCTs） of were collected by searching the electronic databases including CNKI,Wan Fang Data and VIP Data. Two reviewers independently screened literatures according to the inclusion and exclusion criteria,extracted data,and assessed the risk of bias of included studies. Meta-analysis was conducted by Rev Man 5. 2. 5 software. Results A total of 8 RCTs involving 1087 patients were included. The results of meta-analysis showed that： The difference for curative effects between small-needle-knife therapy group and non-small-needle-knife therapy group has statistical significance [OR = 4. 17,95% CI（ 2. 68-4. 68）,P 0. 00001]. Subgroup analysis showed that there was no significant statistical difference between single needle-knife therapy and composite needle-knife therapy in curative effect [x^2= 0. 08,df = 1,p = 0. 78]. Conclusion The curative effect of small-needle-knife therapy on lumbar disc herniation precedes that of non-small-needle-knife therapy,and composite-needle-knife-therapy is not superior to single small-needle-knife therapy. Because of the low quality and, small sample size of the included studies,more high quality RCTs are needed to prove the above conclusion.