国内高压氧治疗颈椎病临床疗效随机对照试验的系统评价

Hyperbaric oxygen treatment for cervical spondylosis in China : a systematic review of randomized controlled trials

目的系统评价国内高压氧治疗(HBOT)颈椎病的临床疗效。方法计算机检索中国知网(CNKI)、万方、维普等中文数据库,全面收集高压氧治疗颈椎病的随机对照试验(RCT),检索时限均为建库到2017年6月。由两位研究者共同评价所纳入研究的质量,并采用Rev Man 5.2软件进行Meta分析。结果 (1)共纳入17个试验1 490例患者,均为非安慰剂随机对照试验,所有试验均是根据HBO治疗后颈椎病症状缓解的有效率评估疗效,采取二分类变量方法进行Meta分析,结果提示:(1)HBO组症状改善明显优于对照组[RR=1.69,95%=(1.51,1.90)];对纳入文献进行漏斗图分析结果显示对称性良好,不存在发表偏倚;(2)有两项研究提出了具体的随机方法;有一项研究因患者不愿意继续试验有16例患者退出。结论基于当前证据,高压氧对颈椎病有明显疗效,但由于纳入研究数量少、质量低,本研究结果的证据强度势必受影响,故有必要进一步开展高质量、大样本随机对照试验来进一步评价其疗效。

Objective To systematically evaluate the clinical efficacy of hyperbaric oxygen treatment(HBOT)for Chinese patients with cervical spondylosis.Methods Randomized controlled trials(RCTs)about HBOT for Chinese patients with cervical spondylosis were comprehensively retrieved in wanfang,CNKI,and VIP.The retrieval time is that the time of Establishment of database to June 2017.Two reviewers independently assessed the quality of the included studies.Then,meta-analysis was performed using RevMan 5.2.Results Seventeen trials involving 1 490 patients were included,all of which were randomized non-placebo controlled trials.All the trials were based on the efficacy of HBO in the treatment of cervical spondylosis,and meta-analysis was performed using two-class variable method.The results of meta-analysis of 17 trials(n=1 490)showed,the improvement of symptoms in the HBO group was better than that in the control group[RR=1.69,95%(1.51,1.90)].The results of the funnel plot analysis of the included literature show that the symmetry is good and there is no publication bias.2.Two studies have put forward specific random methods;There was a study in which 16 patients quit because they were unwilling to continue the trial.Conclusion Current evidence indicates that,HBO has obvious curative effect on the cervical spondylosis,but with small quantity included in the study,low quality,the intensity of evidence from this study is bound to be affected,so It's necessary to further carry out high quality randomized controlled trials with large sample randomized controlled trials to further evaluate the efficacy.