中药复方治疗腰椎间盘突出症患者经皮椎间孔镜术后疼痛的疗效和安全性Meta分析

Meta analysis of efficacy and safety of traditional Chinese medicine compound in the treatment of pain after percutaneous foraminal endoscopy in patients with lumbar disc herniation

目的通过Meta分析,评价中药复方治疗腰椎间盘突出症(lumbar disc herniation,LDH)患者经皮椎间孔镜术后疼痛的安全性及有效性。方法检索中国知网(CNKI)、维普、PubMed、Embase、Cochrane Library和万方6个数据库,纳入2010年1月至2022年1月数据库中有关运用中药复方治疗LDH患者经皮椎间孔镜术后疼痛的安全性和有效性的文献,按照纳入、排除标准选择文章,然后由两位作者对文章进行筛选,提取数据。用Cochrane系统评价方法对纳入研究质量及发表偏倚进行评价,最后通过RevMan 5.4软件进行Meta分析。结果有18篇文献符合本研究的要求,合计1542例患者,其中治疗组773例,对照组769例。Meta分析结果见中药复方能改善LDH经皮椎间孔镜术后患者的视觉模拟疼痛评分(VAS)、日本骨科协会评估治疗分数(JOA)、Oswestry功能障碍指数问卷表评分(ODI)、中医证候评分,提高优良率及有效率。结论中药复方可明显减轻LDH患者经皮椎间孔镜术后疼痛症状,提高手术疗效,促进腰椎功能恢复,减轻术后残余症状。

Objective To evaluate the safety and effectiveness of traditional Chinese medicine compound in the treatment of pain after percutaneous foraminal endoscopy in patients with lumbar disc herniation by Meta-analysis.Methods Six databases including CNKI,VIP,PubMed,Embase,Cochrane Library and Wanfang were searched,and literatures on the safety and efficacy of Chinese herbal compound in the treatment of postoperative pain after percutaneous foraminal endoscopy in LDH patients were included in the databases from January 2010 to January 2022.Articles were selected according to inclusion and exclusion criteria,and then the two authors screened the articles and extracted the data.Cochrane systematic review was used to evaluate the quality and publication bias of the included studies,and Meta-analysis was performed by means of RevMan 5.4 software.Results There were 18 articles that met the requirements of this study,with a total of 1542 patients,including 773 in the treatment group and 769 in the control group.The results of Meta-analysis showed that Chinese medicine compound could improve visual analogue pain scale(VAS),Japanese Orthopaedic Association evaluation treatment score(JOA),Oswestry Disability Index Questionnaire score(ODI),TCM syndrome score,and excellent/good rate as well as effective rate among LDH patients after percutaneous foraminal endoscopy.Conclusion Chinese medicine compound can significantly reduce the pain symptoms of LDH patients after percutaneous foraminal endoscopy,improve the surgical efficacy,promote the recovery of lumbar spine function,and reduce postoperative residual symptoms.