补肾活血汤治疗腰椎间盘突出症临床疗效的Meta分析

Meta-analysis on the Clinical Efficacy of Bushenhuoxue Decoction on Lumbar Disc Herniation

目的系统评价补肾活血汤治疗腰椎间盘突出症(LDH)的临床疗效。方法检索多个数据库中关于补肾活血汤治疗腰椎间盘突出症的随机对照试验(RCTs),文献质量按照Cochran评价系统进行评估;提取数据,并用RevMan5.3软件进行Meta分析。结果经过研究员的初筛和复筛,最终纳入19篇文献,研究总共涉及1791例患者。Meta分析结果显示:与其他治疗方式相比,补肾活血汤在提高总有效率[OR=3.74,95%CI(2.63,5.32),P<0.00001],提高JOA评分[MD=3.62,95%CI(1.36,5.88),P=0.002],降低VAS评分[MD=-1.36,95%CI(-1.73,-0.99),P<0.00001],改善ODI指数[MD=-6.72,95%CI(-8.17,-5.27),P<0.00001],提高优良率[OR=2.34,95%CI(1.14,4.82),P=0.02]方面都有明显的优势,且差异都具有统计学意义。结论补肾活血汤治疗LDH能更好地改善患者的腰部功能以及缓解疼痛,但由于本研究的文献质量较低,并且存在一定的局限性,仍需更多高质量的文献和临床研究来加以证实。

Objective:To systematically evaluate the clinical efficacy of Bushenhuoxue Decoction in the treatment of lumbar disc herniation(LDH).Methods:Randomized controlled trials(RCTs)of Bushenhuoxue Decoction for the treatment of lumbar disc herniation were searched and selected from multiple databases.The quality of the literature was evaluated according to the Cochran evaluation system.Meanwhile the data was extracted and used for meta-analysis by RevMan5.3 software.Results:After initial screening and rescreening by researchers,19 articles were finally included,which involved a total of 1791 patients.Meta-analysis showed that Bushenhuoxue Decoction improved the total effective rate[OR=3.74,95%CI(2.63,5.32),P<0.00001],and improved the JOA score[MD=3.62,95%CI(1.36,5.88),P=0.002],decreased VAS score[MD=-1.36,95%CI(-1.73,-0.99),P<0.00001],improved ODI inder[MD=-6.72,95%CI(-8.17,-5.27),P<0.00001],and improved the excellent rate[OR=2.34,95%CI(1.14,4.82),P=0.02].The Bushenhuoxue Decoction had obvious advantages,and the differences were statistically significant.Conclusions:Bushenhuoxue Decoction can effectively improve patients′lumbar function and alleviate pain.However,because of the low quality of the literature in and some limitations in this study,more high-quality literature and clinical studies are still needed to confirm.