腰痹通胶囊治疗腰椎间盘突出症的Meta分析

A Meta-Analysis:Effect of Yaobitong Capsule on Patients with LDH

目的系统评价腰痹通胶囊比较非甾体抗炎药(NSAIDs)治疗腰椎间盘突出症(LDH)的疗效和安全性,为临床提供循证参考。方法通过计算机检索Cochrane Library、PubMed、Web of Science、中文科技期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库(Wanfang Data),收集自建库以来至2019年6月腰痹通胶囊比较NSAIDs治疗LDH的随机对照试验(RCT),制定纳入标准和排除标准后,筛选出符合标准的文献,评价纳入文献的质量并提取数据,采用RevMan5.3软件对其进行Meta分析。结果共有10篇研究符合标准,合计1088例患者。Meta分析结果显示腰痹通胶囊治疗LDH与NSAIDs比较在提高临床总有效率[OR=4.74,95%CI(3.13,7.17),P<0.00001]、降低VAS评分[MD=-1.26,95%CI(-1.35,-1.17),P<0.00001]、改善白细胞介素-1β(IL-1β)[MD=-0.12,95%CI(-0.14,-0.10),P<0.00001]、白细胞介素-6(IL-6)[MD=-4.14,95%CI(-6.34,-1.93),P=0.0002]、白细胞介素-8(IL-8)[MD=-9.49,95%CI(-11.73,-7.24),P<0.00001]、肿瘤坏死因子-α(TNF-α)[MD=-0.27,95%CI(-0.36,-0.17),P<0.00001]水平方面均有优势,在安全性方面提示不良反应发生率低,临床使用相对安全。结论腰痹通胶囊与NSAIDs比较能明显提高LDH患者的临床疗效、改善相关指标,且不良反应较少。但由于本研究为二次研究,且纳入文献数量较少、质量较低,尚需大样本、高质量随机对照研究对其临床疗效及安全性进一步证实。

Objective:To evaluate the efficacy and safety of Yaobitong Capsule on LDH,and provide evidencebased reference for clinical treatment.Methods:Cochrane Library,PubMed,Web of Science,CNKI,VIP and Wanfang Data were retrieved for RCTs about Yaobitong Capsule on LDH from inception to June 2019.After the inclusion criteria and exclusion criteria were formulated,the literature that met them were screened out;the quality of the included literature was evaluated;the data was extracted,and the meta-analysis was carried out with Revman 5.3 software.Results:10 RCTs involving 1088 patients were included.The results of Meta-analysis indicated that compared with NSAIDs,Yaobitong Capsule had advantages in the total effective rate[OR=4.74,95%CI(3.13,7.17),P<0.00001],decreasing VAS[RR=-1.26,95%CI(-1.35,-1.17),P<0.00001],improving IL-1β[MD=-0.12,95%CI(-0.14,-0.10),P<0.00001],IL-6[MD=-4.14,95%CI(-6.34,-1.93),P=0.0002],IL-8[MD=-9.49,95%CI(-11.73,-7.24),P<0.00001]and TNF-α[MD=-0.27,95%CI(-0.36,-0.17),P<0.00001].In terms of safety,it was suggested that the incidence of adverse reactions be low and clinical use be relatively safe.Conclusion:Compared with NSAIDs,Yaobitong Capsule can significantly improve the clinical efficacy of LDH patients,improve the relevant indicators,with less adverse reactions.However,because this study is a secondary study,and the number of included literature is small and the quality is low,RTCs of large sample and high-quality is needed to further confirm its clinical efficacy and safety.