中药熨烫治疗寒湿型腰椎间盘突出症疗效的Meta分析

Therapeutic effect of traditional Chinese medicine ironing on cold-dampness lumbar disc herniation:a Meta analysis

目的通过Meta分析评价中药熨烫治疗寒湿型腰椎间盘突出症的疗效。方法计算机检索中国知网(CNKI)、万方数据库(Wangfang)、维普数据库(VIP)、Cochrane Library、Embase、Pubmed、Web of Science等中外文数据库,搜集国内外有关中药熨烫治疗寒湿型腰椎间盘突出症的随机对照试验研究,检索时限为从建库至2021年12月。根据Cochrane Handbook 5.1.0对纳入文献进行质量评价后,采用Revman 5.4软件进行Meta分析。结果共纳入11项随机对照试验,包括1186例病人。Meta分析结果显示:中药熨烫治疗在总有效率[OR=4.88,95%CI(2.88,8.27),Z=5.90,P<0.00001]、腰椎JOA评分[MD=3.79,95%CI(2.23,5.35),Z=4.76,P<0.00001]、VAS评分[MD=-1.22,95%CI(-1.79,-0.66),Z=4.23,P<0.0001]、ODI评分[MD=-4.39,95%CI(-5.84,-2.94),Z=5.94,P<0.00001]等方面明显优于对照组。结论中药熨烫治疗寒湿型腰椎间盘突出症疗效显著,值得临床推广应用,但受纳入文献的数量和质量限制,此结论有待更高质量的研究来验证。

Objective To evaluate the efficacy of traditional Chinese medicine(TCM)ironing in the treatment of cold-dampness lumbar disc herniation through Meta-analysis.Methods Chinese and foreign databases such as CNKI,Wangfang,VIP,Cochrane Library,Embase,PubMed,Web of Science were searched by computer to collect randomized controlled trials(RCTs)on the treatment of cold-dampness lumbar disc herniation with traditional Chinese medicine ironing at home and abroad.Search time limit was from the establishment of database to December 2021.After evaluating the quality of the included literature according to Cochrane Handbook 5.1.0,Revman 5.4 software was used for Meta-analysis.Results A total of 11 RCTs involving 1186 patients were included.Meta-analysis results showed that:TCM ironing was notably better than the control group in the total effective rate(OR=4.88,95%CI[2.88,8.27],Z=5.90,P<0.00001),lumbar JOA score(MD=3.79,95%CI[2.23,5.35],Z=4.76,P<0.00001),VAS score(MD=-1.22,95%CI[-1.79,-0.66],Z=4.23,P<0.0001),and ODI score(MD=-4.39,95%CI[-5.84,-2.94],Z=5.94,P<0.00001).Conclusion TCM ironing has significant effect on the treatment of cold-dampness lumbar disc herniation,which is worthy of clinical promotion and application.However,due to the limitations of the quantity and quality of the included literature,this conclusion needs to be verified by higher quality studies.