摘要
目的:对4种中医外治法治疗颈源性头痛(CEH)的随机对照试验进行网状Meta分析,以期为临床治疗该病提供参考依据。方法:计算机检索知网、万方、维普、SinoMed、PubMed、EMbase和Cochrane library数据库中针刀、温针、推拿和普通针刺治疗CEH的随机对照试验(RCT),检索时限为2016年1月1日—2021年5月30日。采用Cochrane偏倚风险评估工具对纳入文献进行筛选和质量评价,运用RevMan 5.3、Gemtc 0.14.3和Stata 14.2进行数据分析。结果:最终纳入31项RCT,共纳入病例2372例,其中试验组1187例,对照组1185例。网状Meta分析结果显示:(1)总有效率。推拿疗效最显著,针刀、温针、推拿的总有效率优于普通针刺;(2)VAS评分。推拿疗效最显著,针刀降低VAS评分优于普通针刺;(3)ROM评分。针刀疗效最显著,温针改善ROM评分优于普通针刺,温针、针刀改善ROM评分优于药物;(4)发作频率。推拿疗效最显著,温针降低发作频率优于普通针刺;(5)持续时间。推拿疗效最显著,温针减少发作持续时间优于普通针刺。结论:中医外治法治疗CEH效果优于药物治疗,且推拿或成为临床最优选择。
Objective:A network Meta-analysis of randomized controlled trials of 4 kinds of traditional Chinese medicine external treatment for cervicogenic headache(CEH).Methods:The RCT regarding warm needle,needle knife,massage and acupuncture for CHE from January 1,2016 to May 30,2021 were searched in databases of CNKI,Wanfang,VIP,sinoMed,PubMed,EMbase and Cochrane Library.The included literature was screened and evaluated by Cochrane bias risk assessment tool,and the data analysis was performed by RevMan 5.3,Gemtc 0.14.3 and Stata14.2.Results:A total of 31 RCTs were included,involving 2372 patients,1187 cases in the observation group and 1185 cases in the control group.The results of the network-like mate analysis show:(1)In term of total effective rate,massage is the most likely to be the best treatment,warm needle and needle knife were superior to acupuncture.(2)In term of VAS score,massage is the most likely to be the best treatment,needle knife were superior to acupuncture.(3)In term of ROM score,needle knife is the most likely to be the best treatment,warm needle,were superior to acupuncture,warm needle,needle knife were superior to drug.(4)In term of seizure frequency,massage is the most likely to be the best treatment,warm needle were superior to acupuncture.(5)In term of duration,massage is the most likely to be the best treatment,warm needle were superior to acupuncture.The differences were statistically significant(P<0.05).Conclusion:The effectiveness of traditional Chinese medicine external treatment for CEH is higher than that of drug treatment,and massage may become the optimal clinical choice.
作者
官磊瑶
徐添
王瑞奇
刘浪辉
许洋
黄春华
GUAN Leiyao;XU Tian;WANG Ruiqi;LIU Langhui;XU Yang;HUANG Chunhua(Jiangxi University of Chinese Medicine,Nanchang 330004,China;The Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006,China.)
出处
《江西中医药大学学报》
2024年第2期39-45,共7页
Journal of Jiangxi University of Chinese Medicine
基金
国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教发[2016]42号)
江西省“双一流”学科(中医学)建设项目(JXSYLXK-ZHYI009)
江西省中医药中青年骨干人才(第三批)培养计划项目(赣中医药科教字[2021]4号)。
关键词
颈源性头痛
中医外治法
针刀
温针
推拿
普通针刺
网状Meta分析
Cervical Headache
Traditional Chinese Medicine External Treatment
Needle Knife
Warm Needle
Massage
Acupuncture
Network Meta-analysis
