中医外治法对神经根型颈椎病疗效及疼痛缓解作用的网状Meta分析

Curative Effect and Pain Relief Effect of External Therapy of Traditional Chinese Medicine for Cervical Spondylotic Radiculopathy: A Network Meta-analysis

目的:采取网状Meta分析的方法比较10种中医外治法治疗神经根型颈椎病的效果以及对疼痛的缓解作用,为医师对治疗方法的选择提供循证医学证据。方法:检索中文数据库CNKI、CBM、VIP和万方中有关中医外治法治疗神经根型颈椎病的随机对照临床试验,检索时间均设定为2010年4月1日至2019年4月1日。由2名研究人员分别检索文献并筛选,纳入文献再进行数据提取和文献方法学质量评价,使用ADDIS1.16.8软件统计分析数据。结果:共纳入38项RCT,3525例神经根型颈椎病患者,包括中医疗法及综合疗法10种。在总有效率方面,10种中医外治法的疗效由优到劣排序为D、I、B、E、C、G、A、J、F、H;在VAS评分方面,涉及8种中医外治法,疗效由优到劣排序为D、G、B、I、J、A、H、F。结论:联合疗法B、C、D、E及单一疗法I能有效治疗神经根型颈椎病,本研究结论仍需更多高质量、大样本研究进行证实。

Objective:To compare the effects of ten external therapies of traditional Chinese medicine(TCM)on cervical spondylotic radiculopathy(CSR)and pain relief,and to provide evidence for physicians'choice of treatment methods.Methods:Randomized controlled clinical trials on external treatment of cervical spondylotic radiculopathy in Chinese databases CNKI,CBM,VIP and Wan Fang were retrieved.The retrieval time was set from April 1,2010 to April 1,2019.Two researchers retrieved and screened the literature separately,then included the literature for data extraction and literature methodological quality evaluation,and used ADDIS 1.16.8 software to analyze the data.Results:A total of 38 RCTs were enrolled.A total of 3525 CSR patients were en-rolled,including 10 TCM therapies and their combination therapies.In terms of total effective rate,the order of 10 external therapies is D,I,B,E,C,G,A,J,F and H.In terms of VAS score,8 external therapies are involved,and the order of curative effect is D,G,B,I,J,A,H and F.Conclusion:Combined therapy B,C,D,E and single therapyⅠcan effectively treat cervical spondylotic radiculopathy.This study still needs more high quality and large sample studies to confirm the conclusions.