脉冲射频术治疗腰骶神经根性疼痛疗效及安全性的系统评价和Meta分析

Efficacy and safety of pulsed radiofrequency for lumbosacral radicular pain:a systematic review and Meta analysis

目的系统评价脉冲射频术(pulsed radio frequency,PRF)治疗腰骶神经根性疼痛(lumbosacral radicular pain,LRP)的有效性及安全性。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、Medline、Embase、Cochrane Library、Cochrane对照试验注册库以及(WHO ICTRP)和Clinical Trial两个临床试验注册库中有关PRF治疗LRP的随机对照试验(randomized controlled trials,RTC),时限为建库至2020年10月。采用Cochrane偏倚风险评估工具行方法学质量评价,采用RevMan 5.3软件行Meta分析。结果共纳入8项PRF治疗LRP的RTC,涉及334例受试者。PRF组与对照组对比:①有效性:疼痛视觉模拟(VAS)评分降低,差异具有统计学意义(P<0.05);Oswestry功能障碍指数(ODI)评分降低,差异无统计学意义(P>0.05)。②安全性:不良事件发生率差异无统计学意义(P>0.05);8项研究均报告未发生严重不良事件。结论与常规治疗相比,PRF在缓解LRP方面可能具有良好的疗效。但受纳入样本量和方法学质量的限制,上述结论仍有待更多高质量的研究予以验证。

Objective To systematically evaluate the efficacy and safety of pulsed radiofrequency(PRF)in the treatment of lumbosacral radicular pain(LRP).Methods The computer was used to search for randomized controlled trials(RTC)of PRF for LRP in CNKI,Wanfang,VIP,Sinomed,Medline,Embase,Cochrane Library,Cochrane Controlled Trials Registry,WHO ICTRP and Clinical Trial database from the establishment to October 2020.Methodological quality was evaluated using the Cochrane risk of bias tool,and Meta-analysis was performed by RevMan 5.3 software.Results Eight RTC researches involving 334 subjects were included.Meta-analysis revealed that compared with the control group,PRF significantly decreased visual analogue scale(P<0.05),while the Oswestry disability index had no statistically significant difference(P>0.05).There was no statistically significant difference in the incidence of adverse events(P>0.05).No serious adverse events were reported in all 8 studies.Conclusion s Compared with conventional treatment,PRF may be effective in alleviating LRP.However,due to the limited sample size and methodological quality,the above conclusions still need to be verified by more high-quality studies.