5种中医外治方法对腰椎间盘突出症患者疼痛影响的网状Meta分析

Effects of five external treatment methods of Traditional Chinese Medicine on pain in patients with lumbar disc herniation: a network Meta-analysis

目的通过网状Meat分析评价5种单一中医外治方法对腰椎间盘突出症(LDH)患者疼痛的影响。方法计算机检索中国知网、万方数据库、维普数据库、中国生物医学数据库、PubMed、Cochrane Library、Web of Science数据库中公开发表的中医外治方法干预LDH患者的相关文献,检索时限为建库至2022年5月31日。由2名研究者根据纳入排除标准独立筛选文献、提取文献信息和质量评价。使用Review Manger 5.4软件绘制偏倚风险图,运用Stata SE 16.0软件进行网状Meta分析。结果纳入12篇文献,共1133例患者,中医外治方法共5种。网状Meta分析结果显示,除穴位贴敷外,刮痧、中药离子导入、中药烫疗、耳穴贴压与常规治疗和护理比较对患者疼痛干预效果差异均有统计学意义(P<0.05);5种中医外治方法两两比较差异均无统计学意义(P>0.05)。排序累积概率图显示,刮痧为LDH患者疼痛的最佳干预方法,SUCRA值为80.3%。结论刮痧疗法是缓解LDH患者疼痛的最佳中医外治方法,但仍需要更多的高质量随机对照试验进一步论证。

Objective To evaluate the effect of five external treatment methods of traditional Chinese medicine on the pain of patients with lumbar disc herniation(LDH)through a network Meta-analysis.Methods The published article on the effect of external treatment methods of Traditional Chinese Medicine in patients with LDH was retrieved by computer in China National Knowledge Infrastructure,WanFang Database,VIP,China Biomedical Database,PubMed,Cochrane Library and Web of Science.The retrieval time limit was from the establishment of the database to May 31,2022.Two researchers independently screened the article according to the inclusion and exclusion criteria,extracted the information and evaluated the quality.Review Manger 5.4 software was used to draw the bias risk map and Stata SE 16.0 software was used to conduct the network Meta-analysis.Results A total of 1133 patients were included in 12 articles,and there were five kinds of external treatment methods of Traditional Chinese Medicine.The results of network Meta-analysis showed that except for acupoint application,scraping,Traditional Chinese Medicine iontophoresis,Traditional Chinese Medicine scalding,auricular point sticking had statistically significant differences in the effect of pain compared with conventional treatment and nursing(P<0.05).There were no statistically significant differences between the five external treatment methods of Traditional Chinese Medicine(P>0.05).The cumulative ranking plot showed that scraping was the best intervention method for pain in LDH patients,with a surface under the cumulative ranking(SUCRA)value of 80.3%.Conclusions Scraping is the best external treatment of traditional Chinese medicine to relieve the pain of LDH patients,but it still needs to be further demonstrated by a large number of high-quality randomized controlled trials.