热敏灸治疗腰椎间盘突出症疗效的Meta分析

Meta-analysis of Therapeutic Effect of Heat-Sensitive Moxibustion on Lumbar Intervertebral Disc Herniation

目的评价单纯热敏灸疗法治疗腰椎间盘突出症(Lumbar Disc Herniation,LDH)的疗效及安全性。方法在CNKI、WanFang、VIP、CBM、Pubmed数据库中,检索2008年1月1日—2019年2月28日应用单纯热敏灸为观察组干预措施治疗腰椎间盘突出症随机对照研究文献。由两名研究人员独立地对这些研究的基本特征和方法学进行质量评价,使用RevMan 5.3软件对治疗效应(有效率、治愈率、M-JOA、VAS、不良反应、随访)进行Meta分析。结果共纳入15篇文献,共1508例患者。Meta分析结果显示:热敏灸组临床有效率优于对照组[RR=1.14,95%CI(1.09,1.19)];热敏灸组临床治愈率优于对照组[RR=1.93,95%CI(1.55,2.41)];热敏灸组M-JOA评分优于对照组[MD=-0.25,95%CI(-0.68,0.18)];热敏灸组VAS疗效评分优于对照组[MD=0.08,95%CI(-1.24,1.08)];7项研究提及未见明显不良反应;11项研究提及随访。结论单纯热敏灸疗法组与对照组相比,在治疗腰椎间盘突出症方面有一定的临床疗效优势。

Objective To evaluate the efficacy and safety of single heat-sensitive moxibustion in the treatment of lumbar disc herniation(LDH).Methods In CNKI,WanFang,VIP,CBM and Pubmed databases,we retrieved the literature of randomized controlled study on the treatment of lumbar intervertebral disc herniation by single heat-sensitive moxibustion from January 1,2008 to February 28,2019.Two researchers independently evaluated the basic characteristics and methodology of these studies.RevMan5.3 software was used for Meta-analysis of the therapeutic effects(effective rate,cure rate,M-JOA,VAS,adverse reactions and follow-up).Results A total of 15 articles and 1508 patients were included.Meta-analysis showed that the clinical effective rate of single heat-sensitive moxibustion group was better than that of control group[RR=1.14,95%CI(1.09,1.19)].The clinical cure rate of single heat-sensitive moxibustion group was better than that of control group[RR=1.93,95%CI(1.55,2.41)].The M-JOA score of the single heat-sensitive moxibustion group was better than that of the control group[MD=-3.13,95%CI(-4.65,-1.62)].The VAS score of single heat-sensitive moxibustion group was better than that of control group[MD=-1.91,95%CI(-3.32,-0.50)].Seven studies mentioned no significant adverse reactions.Eleven studies mentioned follow-up.Conclusion Compared with the control group,the observation group with single heat-sensitive moxibustion therapy has certain clinical curative effect advantages on treating lumbar disc herniation.