督灸治疗腰椎间盘突出症临床疗效的meta分析

Clinical effect of governor meridian moxibustion on treatment of lumbar disc protrusion: A meta analysis

目的:探讨督灸疗法对腰椎间盘突出症的临床疗效。方法:检索中国知网、维普、万方、中国生物医学文献数据库以及Web of ScienceTMCore Collection、EBSCO Medline、Pub Med、OVID、the Cochrane Library等数据库,收集督灸及督灸联合疗法治疗腰椎间盘突出症的相关随机对照试验,检索时间限定为建库至2021年10月,按照纳入与排除的标准筛选文献、提取资料,对最终纳入的研究进行方法学的质量评价,并用Review Manager 5.3软件对所得结果进行统计分析。结果 :纳入24个随机对照试验(共2 379例)。Meta分析结果显示,与针刺、电针、推拿等对照组相比,采用督灸治疗组能提高临床疗效[RR=1.17,95%CI(1.13,1.20),P<0.001],减轻患者的疼痛[MD=-1.56,95%CI(-1.89,-1.22),P<0.001],在一定程度上能改善患者的功能障碍[MD=4.84,95%CI(3.87,5.82),P<0.001]。漏斗图分析显示纳入的文献可能潜在发表偏倚。结论:督灸疗法治疗腰椎间盘突出症疗效显著,值得广泛使用,但鉴于纳入研究的高质量文献数量少、样本量较小、随访时间短,因此需要高质量的随机对照研究来进一步确定督灸疗法对于腰椎间盘突出症的长期治疗作用。

Objective:To explore the clinical effect of governor meridian moxibustion on lumbar intervertebral disc protrusion. Methods:Randomized controlled trials on treatment of lumbar intervertebral disc protrusion with governor meridian moxibustion and combined governor meridian moxibustion were retrieved from CNKI,VIP,Wan Fang Data,CBM,Web of Science;Core Collection,EBSCO Medline,Pub Med,OVID,the Cochrane Library,and other databases. The time was from the inception of the database until October 2021. The studies were screened according to the inclusion and exclusion criteria,extracted,and evaluated for quality assessment. The data were analyzed with Review Manager 5.3 software. Results:A total of 24 randomized controlled trials(2 379 cases in total)were included. Meta-analysis results showed that compared with control groups such as acupuncture,electroacupuncture,and massage,the governor meridian treatment improved the clinical efficacy[RR=1.17,95%CI(1.13,1.20),P<0.001],relieved patients’ pain[MD=-1.56,95%CI(-1.89,-1.22),P<0.001],and improved patients’ dysfunction to a certain extent[MD=4.84,95%CI(3.87,5.82),P<0.001]. Funnel plot analysis showed that the included literature may be potentially biased in publication. Conclusion:Governor meridian moxibustion has a significant effect on the treatment of lumbar disc protrusion and is worthy of widespread use. However,given the small number of high-quality literature included in the study,the small sample size,and the short follow-up time,high-quality randomized controlled trials are needed to further study the long-term therapeutic effect of governor meridian moxibustion.