目的:通过网状meta系统评价不同针灸疗法治疗腰椎间盘突出症的有效性。方法:通过计算机检索PubMed、Embase、Cochrane library、Web of science、中国期刊全文数据库、万方数据库、维普数据库和中国生物医学文献数据库,检索时间为建库至...目的:通过网状meta系统评价不同针灸疗法治疗腰椎间盘突出症的有效性。方法:通过计算机检索PubMed、Embase、Cochrane library、Web of science、中国期刊全文数据库、万方数据库、维普数据库和中国生物医学文献数据库,检索时间为建库至2020年1月1日,由两位研究员依据纳排标准进行文献筛选、质量评价和数据提取,采用stata16.0进行网状meta分析。结果:共纳入69个RCTs,涉及6168例腰椎间盘突出症患者,5种针刺疗法(温针灸、火针、电针、针灸埋线、普通针刺),网状meta分析的结果提示:电针疗效劣于温针灸、针灸埋线,普通针刺疗效劣于温针灸、火针、电针、针灸埋线,且差异具有统计学意义(P<0.05)。在有效率方面,针灸埋线>温针灸>火针>电针>普通针刺。结论:5种针刺方法在治疗腰椎间盘突出症方面,针灸埋线的临床疗效优于其他4种干预措施。但本次研究的文献质量和数量有限,研究结论需要多中心、大样本的高质量RCT验证。展开更多
Objective: To compare the risk angle and safety angle of n eedli ng Ya me n (GV 15) betwee n the atla nto-axial dislocati on (AAD) patients and healthy subjects. Methods: A total of 177 AAD patients diagnosed and trea...Objective: To compare the risk angle and safety angle of n eedli ng Ya me n (GV 15) betwee n the atla nto-axial dislocati on (AAD) patients and healthy subjects. Methods: A total of 177 AAD patients diagnosed and treated at the Center of Upper Cervical Vertebra of Beijing Chin a-Japa n Frie ndship Hospital betwee n January 2010 and January 2018 were in eluded in the AAD group. Ano ther 207 healthy subjects were included in the normal group. There were totally 191 males and 193 females. The MRI sean was performed for the cervical vertebrae to measure the risk angle and safety angle of acup un cture at Ya me n (GV 15) on the sagittal image. Results: In the AAD group, the risk angle was (13.14±3.99)° and the relative safety angle was (10.31±3.23)° for the perpendicular needling, while the oblique needling risk angle was (9.09±3.09)° for the male;the risk angle was (12.12±2.74)° and the relative safety angle was (10.56±2.09)° for the perpendicular needling, while the oblique needling risk angle was (9.70±2.95)° for the female. In the normal group, the risk angle was (7.89±1.59)° and the relative safety angle was (10.21±3.55)° for the perpendicular needling, while the oblique needling risk angle was (16.07±1.77)° for the male;the risk angle was (6.93±1.45)° and the relative safety angle was (10.70±2.94)° for the perpendicular needling, while the oblique needling risk angle was (14.89±2.18)° for the female. The perpendicular needling risk angles for the males and females in the AAD group were larger than those in the normal group, and the differences were statistically significant (both P<0.01);for the inner-group comparison, there was no sigrHficant difference in the perpendicular needling risk angle between the male and the female in the AAD group (P>0.05);however, the perpendicular needling risk angle for the male was larger than the female, and the differenee was statistically significant in the normal group (P<0.01). There were no sign讦icant differences in the relative safety angle for both the male and the female between the AAD group and the normal group (both P>0.05). For the inner-group comparison, there was no sign讦icant differenee in the relative safety angle between the male and the female (P>0.05). The oblique needling risk angles for both the males and females were smaller in the AAD group than those in the normal group, and the differences were statistically sign讦icant (both P<0.01);the oblique needling risk angle for the male was not significantly different from that for the female in the AAD group (P>0.05);in the normal group, the oblique needling risk angle for the male was larger than that for the female, and the differenee was statistically significant (P<0.01). Conclusion: Un der the AAD condition, the risk angle and safety angle of acup un cture at Ya me n (GV 15) cha nge significantly, perpe ndicular n eedli ng should be better if performed slightly lower tha n the horiz on tai di recti on, and the oblique needling should be safer across the occipital foramen toward the occipital bone.展开更多
文摘目的:通过网状meta系统评价不同针灸疗法治疗腰椎间盘突出症的有效性。方法:通过计算机检索PubMed、Embase、Cochrane library、Web of science、中国期刊全文数据库、万方数据库、维普数据库和中国生物医学文献数据库,检索时间为建库至2020年1月1日,由两位研究员依据纳排标准进行文献筛选、质量评价和数据提取,采用stata16.0进行网状meta分析。结果:共纳入69个RCTs,涉及6168例腰椎间盘突出症患者,5种针刺疗法(温针灸、火针、电针、针灸埋线、普通针刺),网状meta分析的结果提示:电针疗效劣于温针灸、针灸埋线,普通针刺疗效劣于温针灸、火针、电针、针灸埋线,且差异具有统计学意义(P<0.05)。在有效率方面,针灸埋线>温针灸>火针>电针>普通针刺。结论:5种针刺方法在治疗腰椎间盘突出症方面,针灸埋线的临床疗效优于其他4种干预措施。但本次研究的文献质量和数量有限,研究结论需要多中心、大样本的高质量RCT验证。
文摘Objective: To compare the risk angle and safety angle of n eedli ng Ya me n (GV 15) betwee n the atla nto-axial dislocati on (AAD) patients and healthy subjects. Methods: A total of 177 AAD patients diagnosed and treated at the Center of Upper Cervical Vertebra of Beijing Chin a-Japa n Frie ndship Hospital betwee n January 2010 and January 2018 were in eluded in the AAD group. Ano ther 207 healthy subjects were included in the normal group. There were totally 191 males and 193 females. The MRI sean was performed for the cervical vertebrae to measure the risk angle and safety angle of acup un cture at Ya me n (GV 15) on the sagittal image. Results: In the AAD group, the risk angle was (13.14±3.99)° and the relative safety angle was (10.31±3.23)° for the perpendicular needling, while the oblique needling risk angle was (9.09±3.09)° for the male;the risk angle was (12.12±2.74)° and the relative safety angle was (10.56±2.09)° for the perpendicular needling, while the oblique needling risk angle was (9.70±2.95)° for the female. In the normal group, the risk angle was (7.89±1.59)° and the relative safety angle was (10.21±3.55)° for the perpendicular needling, while the oblique needling risk angle was (16.07±1.77)° for the male;the risk angle was (6.93±1.45)° and the relative safety angle was (10.70±2.94)° for the perpendicular needling, while the oblique needling risk angle was (14.89±2.18)° for the female. The perpendicular needling risk angles for the males and females in the AAD group were larger than those in the normal group, and the differences were statistically significant (both P<0.01);for the inner-group comparison, there was no sigrHficant difference in the perpendicular needling risk angle between the male and the female in the AAD group (P>0.05);however, the perpendicular needling risk angle for the male was larger than the female, and the differenee was statistically significant in the normal group (P<0.01). There were no sign讦icant differences in the relative safety angle for both the male and the female between the AAD group and the normal group (both P>0.05). For the inner-group comparison, there was no sign讦icant differenee in the relative safety angle between the male and the female (P>0.05). The oblique needling risk angles for both the males and females were smaller in the AAD group than those in the normal group, and the differences were statistically sign讦icant (both P<0.01);the oblique needling risk angle for the male was not significantly different from that for the female in the AAD group (P>0.05);in the normal group, the oblique needling risk angle for the male was larger than that for the female, and the differenee was statistically significant (P<0.01). Conclusion: Un der the AAD condition, the risk angle and safety angle of acup un cture at Ya me n (GV 15) cha nge significantly, perpe ndicular n eedli ng should be better if performed slightly lower tha n the horiz on tai di recti on, and the oblique needling should be safer across the occipital foramen toward the occipital bone.
