摘要
目的:评价钩活术治疗腰椎间盘突出症的临床效果。方法:分别检索中国知网、万方、维普、中国生物医学、PubMed、Cochrane图书馆等数据库中发表的钩活术治疗腰椎间盘突出症的RCT的相关文献,检索文献语种不限,检索时间均设定为从建库至2022年10月。2名研究员依据纳入和排除标准,分别独立完成文献筛选、资料提取工作,然后2名研究者的研究结果进行比较,交叉核对,确定最终纳入的文献,之后依据Cochrane偏倚风险评估工具对最终纳入的RCT研究进行文献质量评价。将提取后的数据导入RevMan 5.4软件,进行统计学异质性检验和Meta分析。结果:最终纳入8篇文献,均为RCT研究,共1090名患者。Meta分析显示钩活术治疗腰椎间盘突出症临床有效率(RR=4.68,95%CI[2.55,8.59],P<0.00001)明显优于对照组,在改善视觉模拟疼痛(VAS)评分(RR=1.22,95%CI[0.11,2.34],P<0.00001)、JOA评分评价(RR=4.52,95%CI[4.02,5.02],P<0.00001)、腰椎功能评价方面(RR=3.41,95%CI[1.85,4.97],P<0.0001),钩活术组均优于对照组。结论:该次研究表明钩活术治疗腰椎间盘突出症相较于传统的治疗方法具有明显优势,能提高腰椎间盘突出症的临床有效率,改善视觉模拟疼痛(VAS)评分、JOA评分、腰椎功能,但仍需要更多样本量大且高质量的RCT验证。
Objective:To evaluate the clinical effect of hooking surgery in the treatment of lumbar disc herniation.Methods:Relevant literature on RCTs of hook mobilization in the treatment of lumbar disc herniation published in databases such as CNKI,Wanfang,VIP,China Biomedicine,PubMed,and Cochrane Library were searched.There was no limit to the language of the literature and the search time.It is set from the establishment of the database to October 2022.Two researchers independently completed literature screening and data extraction based on the inclusion and exclusion criteria.Then the research results of the two researchers were compared and cross-checked to determine the final included literature.The final included literature was then evaluated based on the Cochrane risk of bias assessment tool.RCT studies were evaluated for literature quality.The extracted data were imported into RevMan 5.4 software for statistical heterogeneity testing and meta-analysis.Results:Eight documents were finally included,all of which were RCT studies,with a total of 1090 patients.Meta-analysis showed that the clinical effectiveness of hookwork in the treatment of lumbar disc herniation(RR=4.68,95%CI[2.55,8.59],P<0.00001)was significantly better than that of the control group,and it improved the visual analogue pain(VAS)score(RR=1.22,95%CI[0.11,2.34],P<0.00001),JOA score evaluation(RR=4.52,95%CI[4.02,5.02],P<0.00001),lumbar spine function evaluation(RR=3.41,95%CI[1.85,4.97],P<0.0001),the hook surgery group was better than the control group.Conclusion:This study shows that hook mobilization has obvious advantages over traditional treatment methods in the treatment of lumbar disc herniation.It can improve the clinical effectiveness of lumbar disc herniation and improve visual analogue pain(VAS)scores,JOA scores,and lumbar spine function.,but more RCT validations with large sample sizes and high quality are still needed.
作者
姜瑞
牟双林
谭爱华
张征
朱文胜
JIANG Rui;MOU Shuanglin;TAN Aihua;ZHANG Zheng;ZHU Wensheng(Hubei University of Traditional Chinese Medicine,Hubei Wuhan 430065,China;Huanggang Hospital of Traditional Chinese Medicine Affiliated of Hubei University of Chinese Medicine,Hubei Huanggang 438000,China;Beijing University of Chinese Medicine Postdoctoral Station,Beijing 100007,China)
出处
《中医药临床杂志》
2023年第12期2371-2376,共6页
Clinical Journal of Traditional Chinese Medicine
基金
湖北省自然科学基金项目(NO.2022CFB391)
黄冈市科技创新专项(编号:YBXM20230003-3)。
