摘要
【目的】评价头针治疗腰椎间盘突出症的Meta分析和试验序贯分析(TSA)。【方法】检索中国知网数据库(CNKI)、维普数据库(VIP)、中国生物医学数据库(CBM)、万方数据库、PubMed、Embase等数据库,筛选出采用头针及头针联合其他疗法治疗腰椎间盘突出症的随机对照试验(RCT)文献,并应用Cochrane评价员手册进行风险偏倚评估,采用Stata 12.0软件对纳入研究的有效率、腰痛疾患日本骨科协会(JOA)评分、视觉模拟量表(VAS)评分进行Meta分析以及TSA分析,采用Excel2016进行穴位频率统计分析。【结果】共纳入9篇文献,涉及785例患者,最终结果显示头针及联合其他疗法(治疗组)治疗腰椎间盘突出症的VAS评分、JOA评分均优于对照组,治疗组的总有效率优于对照组,差异有统计学意义(P<0.01)。并对包含有效率的6个临床研究进行试验序贯分析,累计的Z值同时穿过了传统界线和TSA界线,且累计信息已达到期望值,证明了有治疗效果。穴位频率统计结果显示顶中线、顶颞后斜线、顶旁1线的穴位使用频率最高。【结论】头针治疗腰椎间盘突出症的临床疗效优于单纯使用电针、推拿、体针,但由于纳入文献质量较低,此结论仍需进一步高质量RCT文献证明。
Objective To evaluate the Meta-analysis and sequential analysis of scalp acupuncture therapy for lumbar disc herniation. Methods The literatures on randomized controlled trials(RCTs)of scalp acupuncture alone or combined with other therapies treatment for lumbar disc herniation were screened out from CNKI,VIP,CBM,Wanfang,Pub Med,and Embase databases,and were given risk of bias assessment by Cochrane member handbook. And then Meta-analysis and sequential analysis of the response rate,Japanese Orthopaedic Association(JOA)score,and Visual analogue scale(VAS)score in included RCTs were carried out by Stata 12.0 software,and the statistical analysis of point frequency was performed by Excel 2016. Results A total of 9 literatures were included, involving 785 patients. The final results of JOA score, VAS score of lumbar disc herniation after treatment with scalp acupuncture alone or combined with other therapies were superior to those of the control group, and the total response rate in the treatment group was superior to that in the control group(P < 0.01).The sequential analysis results of 6 clinical tests involving total response rate showed that accumulated Z value passed through conventional boundary line and test sequential analysis boundary line,and accumulated data arrived to expectancy value,proving the therapies were effective. Besides,the selection frequency of acupoints at parietal midline, parietal temporal posterior oblique line and parietal 1-line was the highest. Conclusion Scalp acupuncture has better clinical therapeutic effect for lumbar disc herniation than electro-acupuncture,massage or body acupuncture alone. However,due to poor quality of the included literatures,this conclusion still needs to be proved by high-quality articles on RCTs.
作者
朱碧锋
邸安琪
谢彬
刘紫欣
黄帆
范志勇
吴山
ZHU Bi-Feng;DI An-Qi;XIE Bin;LIU Zi-Xin;HUANG Fan;FAN Zhi-Yong;WU Shan(The Second Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Clinical Medical College of Acupuncture,Moxibustion and Rehabilitation,Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Foshan Medical College,Guangzhou 528000 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2020年第8期1522-1528,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广东省财政厅资助项目(编号:粤财教[2016]387号)。
关键词
头针
腰椎间盘突出症
随机对照试验
META分析
试验序贯分析
scalp acupuncture
lumbar disc herniation
randomized controlled trial
Meta-analysis
sequential analysis
