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手法治疗腰椎间盘突出症临床随机对照试验系统评价
Hits: 2712   Download times: 1400   Received:February 08, 2010    
作者Author单位UnitE-Mail
李林 LI lin 上海中医药大学附属曙光医院骨伤科 上海市中医药研究院骨伤科研究所,上海 200021 Department of Orthopaedics,Shuguang Hospital Affiliated to Shanghai University of TCM,Shanghai 200021,China  
詹红生 ZHAN Hong-sheng 上海中医药大学附属曙光医院骨伤科 上海市中医药研究院骨伤科研究所,上海 200021 Department of Orthopaedics,Shuguang Hospital Affiliated to Shanghai University of TCM,Shanghai 200021,China shgsyjs@139.com 
张明才 ZHANG Ming-cai 上海中医药大学附属曙光医院骨伤科 上海市中医药研究院骨伤科研究所,上海 200021 Department of Orthopaedics,Shuguang Hospital Affiliated to Shanghai University of TCM,Shanghai 200021,China  
陈博 CHEN Bo 上海中医药大学附属曙光医院骨伤科 上海市中医药研究院骨伤科研究所,上海 200021 Department of Orthopaedics,Shuguang Hospital Affiliated to Shanghai University of TCM,Shanghai 200021,China  
元唯安 YUAN Wei-an 上海中医药大学附属曙光医院骨伤科 上海市中医药研究院骨伤科研究所,上海 200021 Department of Orthopaedics,Shuguang Hospital Affiliated to Shanghai University of TCM,Shanghai 200021,China  
石印玉 SHI Yin-yu 上海中医药大学附属曙光医院骨伤科 上海市中医药研究院骨伤科研究所,上海 200021 Department of Orthopaedics,Shuguang Hospital Affiliated to Shanghai University of TCM,Shanghai 200021,China  
期刊信息:《中国骨伤》2010年23卷,第9期,第696-700页
DOI:10.3969/j.issn.1003-0034.2010.09.017
基金项目:1.国家重点基础研究发展计划(973)项目(编号:2007CB512701);2.上海市科委重点项目(编号:09411953400)


目的:评价手法治疗腰椎间盘突出症的有效性和安全性,分析目前临床研究的现状。

方法:检索PubMed、OVID、Cochrane 图书馆、CBM- disc数据库、CNKI数据库、VIP数据库以及手工检索,共收集手法治疗腰椎间盘突出症文献832篇,其中8篇符合纳入研究标准。Cochrane 系统评价手册进行质量评价,并对8篇文献采用RevMan4.2进行Meta分析。

结果:纳入的8篇文献共911例患者。8篇文献的治愈率汇总合并OR为3.65,95%CI为[2.15,6.20];有效率汇总合并OR为3.56,95%CI为[2.35,5.38].手法组对腰椎间盘突出症的治愈率、有效率明显优于其他疗法(除手法之外或药物、或牵引、或针灸、或微波热疗,以下简称“其他疗法”)组(P<0.01) .

结论:目前纳入研究显示手法治疗腰椎间盘突出症安全、有效,手法对腰椎间盘突出症的治愈率、有效率优于其他疗法。但由于纳入文献的数量有限且质量不是很高,结论尚不确定,需高质量证据来进一步验证。
[关键词]:手法,骨科  腰椎  椎间盘移位  随机对照试验  期刊论文  系统分析
 
Systematic review of clinical randomized controlled trials on manipulative treatment of lumbar disc herniation
Abstract:

Objective: To evaluate the efficacy and safety of the manipulative treatment on lumbar disc herniation and analyze the current status of clinical studies.

Methods: The PubMed,OVID,Cochrane Library,CBM-disc database,CNKI database and VIP Database were retrieved,and 832 literatures on manipulative treatment for lumbar disc herniation were collected,in which 8 articles met the inclusion criteria. Cochrane systematic review was used to evaluate the quality;and RevMan 4.2 was used for Meta Analysis of Literatures.

Results: There were total 911 patients in the 8 articles. The summary OR for the combined cure rate of the 8 articles was 3.65,and the 95% CI was[2.15,6.20]. The summary OR for the combined efficiency was 3.56,and the 95% CI was [2.35,5.38]. The cure rate and effective rate of the patients in manipulative group were superior to those of patients treated with other methods such as drugs,traction,acupuncture,microwave thermotherapy(all the methods were called as “other therapies”).

Conclusion: This study shows that manipulative treatment on lumbar disc herniation is safe,effective,and both cure rate and the effective rate is better than other therapies. But the number of documents is limited and the quality is not very high,and the conclusion is still uncertain,high-quality evidence is needed to be further validated.
KEYWORDS:Manipulation,orthopedic  Lumbar vertebrae  Intervertebral disk displacement  Randomized controlled trials  Journal article  Systems analysis
 
引用本文,请按以下格式著录参考文献:
中文格式:李林,詹红生,张明才,陈博,元唯安,石印玉.手法治疗腰椎间盘突出症临床随机对照试验系统评价[J].中国骨伤,2010,23(9):696~700
英文格式:LI lin,ZHAN Hong-sheng,ZHANG Ming-cai,CHEN Bo,YUAN Wei-an,SHI Yin-yu.Systematic review of clinical randomized controlled trials on manipulative treatment of lumbar disc herniation[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(9):696~700
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