红花注射液治疗腰椎间盘突出症Meta分析

Clinical Efficacy of Honghua Injection for Lumbar Disc Herniation:A Meta-analysis

目的评价红花注射液治疗腰椎间盘突出证的临床疗效和安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、SinoMed、CNKI和WanFang Data数据库,纳入西医常规治疗基础上给予红花注射液治疗对比单纯西医常规治疗腰椎间盘突出症的随机对照试验,检索时限均从建库至2018年11月。由2位研究员按纳入与排除标准独立进行文献筛选、资料提取和质量评价后,并采用RevMan 5.3软件进行Meta分析。结果共纳入7个随机对照试验,包括745例患者。Meta分析结果显示:与西医常规治疗对照组相比,红花注射液联合医西常规治疗组的临床疗效有效率[RR=1.25,95%CI(1.11,1.40),P=0.0002],患者VAS评分[MD=-1.34,95%CI(-1.69,-0.98),P<0.00001]和JOA评分[MD=2.87,95%CI(2.26,3.48),P<0.00001]均明显高于对照组,差异均有统计学意义。在不良反应方面[RR=1.23,95%CI(0.51,2.95),P=0.65]与对照组相比,差异无统计学意义。结论红花注射液联合西医常规治疗治疗较单纯西医常规治疗,可以显著提高腰椎间盘突出症患者治疗的疗效。但受纳入研究质量和数量限制,本研究结论尚需开展更多高质量、大样本随机对照试验进行验证。

Objective To systematically review the efficacy and safety of Honghua Injection for lumbar disc herniation.Methods Databases including PubMed,EMbase,The Cochrane Library,SinoMed,CNKI and WanFang were searched to collect randomized controlled trials(RCTs)about Honghua Injection combined with western medical conventional therapy versus western medical conventional therapy alone for lumbar disc herniation from inception to November 2018.According to the inclusion and exclusion criteria,two reviewers independently screened the literature,extracted the data,and assessed the methodological quality of included studies.Finally,Meta-analysis was performed using RevMan 5.3.Results A total of 7 RCTs involving 745 patients were included.The results of Meta-analysis showed compared with conventional therapy group,the Honghua Injection group could obviously improve the clinical efficiency[RR=1.25,95%CI(1.11,1.40),P=0.0002],VAS score[MD=-1.34,95%CI(-1.69,-0.98),P<0.00001]and JOA score[MD=2.87,95%CI(2.26,3.48),P<0.00001].In terms of adverse reactions,there was no statistical significance compared with the control group[RR=1.23,95%CI(0.51,2.95),P=0.65].Conclusions Compared with western medical conventional therapy alone,Honghua Injection combined with conventional therapy can improve the clinical efficiency.Due to the limited quality and quantity of the included studies,more high quality and large-scale sample RCTs are needed to verify the above conclusion.