黄芪桂枝五物汤联合针灸推拿治疗颈椎病的Meta分析

A Meta analysis of treating cervical spondylosis with the Huangqi Guizhi Wuwu decoction plus acupuncture and massage

目的:Meta分析黄芪桂枝五物汤联合针灸推拿治疗颈椎病(简称联合疗法)的临床疗效。方法:检索中国期刊全网数据库、万方、维普等数据库从建库到现在有关联合疗法的临床研究文献;整理并筛选符合纳入标准的相关文献,提取其中的有关信息,建立Excel数据库。利用修订后的Jadad量表及Cochrane偏倚风险评估工具对纳入的文献进行质量评价,并用Revman 5.4软件对其中的数据进行Meta分析及异质性检验。结果:(1)试验组的总有效率明显高于对照组[RR=1.22,95%CI(1.14,1.29),P<0.00001];(2)试验组的痊愈率高于对照组[RR=1.55,95%CI(1.19,2.00),P=0.0010];(3)试验组在颈椎功能评分上具有显著优势[SMD=2.31,95%CI(1.18,3.44),P<0.0001],差异具有统计学意义;(4)试验组的疼痛情况评分较对照组改善明显[SMD=-3.01,95%CI(-4.48,-1.53),P<0.0001]。结论:黄芪桂枝五物汤联合针灸推拿治疗颈椎病临床疗效显著,能够提高患者的生活质量且不良反应少,值得临床推广。

Objective:Based on Meta technology,the clinical efficacy of Huangqi Guizhi Wuwu Decoction(黄芪桂枝五物汤)combined with acupuncture and massage in the treatment of cervical spondylosis were assessed.Methods:Using CNKI,Wanfang Database,VIP Database and China Biomedical Literature Database,the clinical research literature on the Huangqi Guizhi Wuwu decoction combined with acupuncture and massage for cervical spondylosis was searched from the establishment of the library to the present.And the relevant literature that met the inclusion criteria was sorted out and screened,the relevant information was extracted to the Excel database.The included literature was quality evaluated using the revised Jadad scale and the Cochrane Bias Risk Assessment Tool,and the data were meta-analyzed and tested for heterogeneity using Revman5.4 software.Results:(1)The total effective rate in the treatment group was significantly higher than that in the control group[RR=1.22,95%CI(1.14,1.29),P<0.00001].(2)The recovery rate of the treatmen group was higher than that in the control group[RR=1.55,95%CI(1.19,2.00),P=0.0010].(3)The treatment group had a significant advantage in the score of cervical vertebra function[SMD=2.31,95%CI(1.18,3.44),P<0.0001].The difference was statistically significant.(4)The pain score of the treatmen group was significantly improved compared with the control group[SMD=-3.01,95%CI(-4.48,-1.53),P<0.0001].Conclusion:The Huangqi Guizhi Wuwu decoction combined with acupuncture and massage has a remarkable clinical effect on cervical spondylosis,which can improve the quality of life of patients and have fewer side effects,and it is worth vigorously promoting in the clinic.