补阳还五汤联合手术治疗腰椎管狭窄症有效性的Meta分析

Effectiveness analysis of BuyangHuanwu decoction combined with operation in the treatment of lumbar spinal stenosis:a Meta-analysis

目的:评价补阳还五汤联合手术治疗腰椎管狭窄症的有效性。方法:应用PubMed、Embase、Web of Science、万方(WanFang)、中国知网(CNKI)、中国生物医学文献库(CBM)等数据库检索有关补阳还五汤结合手术治疗腰椎管狭窄症的文献,使用Cochrane偏倚风险评估标准对文献进行评价,应用RevMan软件进行数据分析。结果:共纳入文献10篇,涉及腰椎管狭窄症患者728例,Meta分析结果显示补阳还五汤结合手术治疗腰椎管狭窄症优于单纯手术治疗,其中有效率[OR=3.26,95%CI(1.66,6.40),P<0.05]、视觉模拟评分(VAS)[WMD=-0.61,95%CI(-1.11,-0.11),P=0.02]、Owsestry功能障碍指数(ODI)[WMD=-3.09,95%CI(-4.49,-1.70),P<0.05]、日本骨科学会腰椎疗效评分(JOA)[WMD=2.00,95%CI(0.57,3.43),P<0.05]、C反应蛋白水平[WMD=-2.24,95%CI(-2.69,-1.80),P<0.05]。结论:补阳还五汤结合手术治疗腰椎管狭窄症的疗效优于单纯手术治疗,此结论仍需更多大样本、高质量的随机对照研究进行论证。

Objective:To evaluate the effectiveness of BuyangHuanwu decoction combined with operation in the treatment of lumbar spinal stenosis.Methods:Databases such as PubMed,Embase,Web of Science,Wanfang Data,CNKI and CBM were searched to collect the literature on the treatment of lumbar spinal stenosis by BuyangHuanwu decoction combined with operation.The literature was evaluate using Cochrane bias risk assessment criteria and RevMan software for statistical analysis.Results:A total of 10 literatures were included,involving 728 lumbar spinal stenosis patients.Meta-analysis results showed that BuyangHuanwu decoction combined with operation was better than simple operation in the treatment of lumbar spinal stenosis,the effective rate[OR=3.26,95%CI(1.66,6.40),P<0.05],visual analogue scale score[WMD=-0.61,95%CI(-1.11,-0.11),P=0.02],Oswestry disability index score[WMD=-3.09,95%CI(-4.49,-1.70),P<0.05],Japanese orthopaedic association score[WMD=2.00,95%CI(0.57,3.43),P<0.05],C-reactive protein level[WMD=-13.32,95%CI(-21.70,-4.95),P<0.05].Conclusions:BuyangHuanwu decoction combined with operation is better than simple operation in the treatment of lumbar spinal stenosis,which needs to be demonstrated bylarge sample,high quality randomized controlled studies.