悬吊训练治疗慢性非特异性腰痛疗效的系统评价和Meta分析

Efficacy of Sling Exercise Therapy for Chronic Nonspecific Low Back Pain: A Systematic Review and Meta-Analysis

目的:系统评价悬吊训练治疗慢性非特异性腰痛的疗效。方法:检索PubMed、web of science、Pedro、Cochrane library、万方、维普、中国学术期刊(CNKI)、中国生物医学文献数据库(CBM)从建库至2020年6月关于悬吊训练治疗慢性非特异性腰痛的随机对照试验(RCT)研究。根据Cochrane系统评价标准对纳入文献进行质量评估,提取相关数据,采用RevMan 5.4软件进行Meta分析。结果:共纳入23项RCT研究,1679例受试者。Meta分析结果显示,悬吊训练在改善视觉模拟量表(VAS)疼痛评分(MD = −0.25, 95%CI: −0.64~0.15, Z = 1.23, P = 0.22)与中医疗法无差异;悬吊训练在改善视觉模拟量表(VAS)疼痛评分中等病程(MD = −0.60, 95%CI: −1.00~−0.20, Z = 2.95, P = 0.003)和短病程(MD = −1.48, 95%CI: −1.62~1.33, Z = 19.60, P 【0.00001)方面优于运动疗法组,在腰痛功能障碍指数评定量表(ODI)评分长病程(MD = −7.51, 95%CI: −11.48~−3.53, Z = 3.70, P = 0.0002)、中等病程(MD = −9.90, 95%CI: −18.66~−1.13, Z = 2.21, P = 0.03)、短病程(MD = −2.79, 95%CI: −5.54~−0.04, Z = 1.98, P = 0.05)方面均优于运动疗法组;悬吊训练在改善视觉模拟量表(VAS)疼痛评分(MD = −1.70, 95%CI: −2.94~−0.45, Z = 2.67, P = 0.008)和腰痛功能障碍指数评定量表(ODI)评分(MD = −12.74, 95%CI: −15.65~−9.82, Z = 8.55, P 【0.00001)方面优于理疗组。结论:悬吊训练可以一定程度上改善慢性非特异性腰痛患者的疼痛和腰部功能障碍。

Objective: To systematically evaluate the efficacy of sling exercise in the treatment of chronic nonspecific low back pain. Methods: A randomized controlled trial (RCTS) study on sling exercise for chronic nonspecific low back pain was retrieved from PubMed, Web of Science, Pedro, Cochrane Library, Wanfang, VIP, Chinese Academic Journal (CNKI) and Chinese Biomedical Literature Database (CBM) from the establishment of the Database to June 2020. The quality of the included literature was evaluated according to the Cochrane System evaluation criteria, relevant data were extracted, and the RevMan 5.4 software was used for Meta analysis. Results: A total of 23 RCT studies involving 1679 subjects were included. The results of Meta-analysis showed that there was no difference in the improvement of visual analogue scale (VAS) pain score (MD = −0.25, 95%CI: −0.64~0.15, Z = 1.23, P = 0.22) between sling exercise therapy and traditional Chinese medicine. Sling exercise therapy improved visual analogue scale (VAS) pain scores for moderate duration (MD = −0.60, 95%CI: −1.00~−0.20, Z = 2.95, P = 0.003) and short duration (MD = −1.48, 95%CI: −1.62~1.33, Z = 19.60, P <0.00001), better than exercise therapy. For ODI, both long duration (MD = −7.51, 95%CI: −11.48~−3.53, Z = 3.70, P = 0.0002), medium duration (MD = −9.90, 95%CI: −18.66~−1.13, Z = 2.21, P = 0.03), short duration (MD = −2.79, 95%CI: −5.54~−0.04, Z = 1.98, P = 0.05) were better than those of exercise therapy group. Sling exercise therapy improved visual analogue scale (VAS) pain scores (MD = −1.70, 95%CI: −2.94~−0.45, Z = 2.67, P = 0.008) and low back pain dysfunction index rating scale (ODI) scores (MD = −12.74, 95%CI: −15.65~−9.82, Z = 8.55, P <0.00001), both better than physical therapy. Conclusion: Sling exercise can improve the pain and dysfunction of patients with chronic nonspecific low back pain to a certain extent.