中医护理对腰椎间盘突出症疗效影响的Meta分析

Meta Analysis of the Effects of TCM Care on Lumbar Disc Herniation

目的:评价中医护理对腰椎间盘突出症患者的护理效果。方法:确定并提取检索词,设计科学有效的文献检索式,分别检索中文数据库中国知网、维普数据库、中国生物医学文献数据库、万方数字化期刊群,检索外文数据库(The Cochrane Library、Pubmed、EMbase);检索时间为2005年1月至2017年5月;所纳入文献为在常规传统治疗的前提下,以中医护理为观察组来探讨腰椎间盘突出症临床疗效的随机对照试验。运用"Cochrane偏倚评价表"对纳入的文献进行评估,并运用Revman5.3软件分析数据,采用漏斗图分析发表偏倚。结果:共纳入15项国内研究(未见外文研究),合计1 669例腰椎间盘突出症患者,Meta分析结果显示中医护理效果[OR=3.69,95%CI(2.70,5.04)]优于常规护理,2组比较差异有统计学意义。结论:中医护理在提高腰椎间盘突出症临床有效率方面优于常规护理,但由于纳入研究存在方法学缺陷,使得结论的论证强度有一定局限性。

Objective:To assess nursing effects of TCM care on the patients with lumbar disc herniation(LDH).Methods:After confirming,extracting the key words,and designing the scientific and effective literature retrieval strategy,Chinese database of CNKI,VIP and CBM disc and WanFang digital periodicals were searched respectively,as well as foreign database(the Cochrane Library,Pubmed and EMbase),the retrieval time was from January,2005 to May,2017,on the premise of conventional traditional treatment,the included literature was of randomized controlled trials(RCTs)about TCM care affecting clinical effects of LDH as the observation group.“Cochrane bias assessment scales”was used to evaluate the included literature,Revman software 5.3 was adopted to analyze the data,and funnel plot was used to analyze the bias.Results:All 15 domestic studies were included(no foreign researches),altogether 1 669 patients suffering LDH,Meta analysis showed that the effects of TCM care[OR=3.69,95%CI(2.70,5.04)]was superior to these of conventional care,and the difference had statistical meaning.Conclusion:TCM care is superior to conventional care in improving clinical effective rate of LDH,since the included research methodology is flawed,the condusion has cetain limitations.