杵针疗法治疗腰腿痛有效性和安全性的系统评价
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摘要
目的系统评价杵针疗法治疗腰腿痛的临床有效性及安全性,为其临床推广提供循证医学的证据支持。方法计算机检索Pub Med、EMBase、Cochrane Library、Web of Science等外文数据库以及中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普网(VIP)和万方网(Wan Fang)等中文数据库,配合补充检索手段,收集所有杵针治疗腰腿痛的随机对照试验(randomized controlled trial,RCT)。文献筛选后对纳入文献进行资料提取及方法学质量评价,然后实施定性或定量分析。结果共纳入5篇RCT(388例患者)。(1)定性分析的结果证实,杵针疗法治疗腰腿痛的临床疗效肯定,具备良好的有效性及安全性。(2)定量分析的结果显示,杵针疗法能显著提高腰腿痛患者的临床痊愈率和总有效率,与传统针刺疗效相当,其组间差异无统计学意义(P> 0. 05)。结论杵针疗法治疗腰腿痛安全有效,有助于改善腰腿痛患者的临床症状,应在临床中大力推广。
Objective To systematically evaluate the efficacy and safety of pestle needle therapy for lumbocrural pain,and to provide the reference of evidence-based medicine for its clinical expansion. Methods A computer-based retrieval was performed in foreign databases as Pub Med,EMbase,Cochrane Library,Web of Science and Chinese ones as CBM,CNKI,VIP and Wan Fang,and supplementary retrieval was also performed with other sources. All relevant randomized controlled trials( RCTs) were collected to systematically research pestle needle therapy for lumbocrural pain. After literature screening,data extraction and methodologic quality evaluation of the included studies were carried out. Finally,qualitative or quantitative analyses were performed according to actual circumstances. Results A total of 5 RCTs were included,comprising 388 patients.(1) The Results of qualitative analysis confirmed the superior effectiveness of pestle needle therapy in the treatment of lumbocrural pain,with good clinical efficacy and safety.(2) The results of quantitative analysis showed that pestle needle therapy could significantly improve the recovery rate and total effective rate of clinical symptoms in patients with lumbocrural pain. It was equivalent to traditional acupuncture,and there was no significant difference( P > 0. 05). Conclusions The pestle needle therapy is secure and effective in the treatment of lumbocrural pain,which is beneficial to relieve the clinical symptoms of patients with lumbocrural pain and should be widely promoted in clinical practice.
Objective To systematically evaluate the efficacy and safety of pestle needle therapy for lumbocrural pain,and to provide the reference of evidence-based medicine for its clinical expansion. Methods A computer-based retrieval was performed in foreign databases as Pub Med,EMbase,Cochrane Library,Web of Science and Chinese ones as CBM,CNKI,VIP and Wan Fang,and supplementary retrieval was also performed with other sources. All relevant randomized controlled trials( RCTs) were collected to systematically research pestle needle therapy for lumbocrural pain. After literature screening,data extraction and methodologic quality evaluation of the included studies were carried out. Finally,qualitative or quantitative analyses were performed according to actual circumstances. Results A total of 5 RCTs were included,comprising 388 patients.(1) The Results of qualitative analysis confirmed the superior effectiveness of pestle needle therapy in the treatment of lumbocrural pain,with good clinical efficacy and safety.(2) The results of quantitative analysis showed that pestle needle therapy could significantly improve the recovery rate and total effective rate of clinical symptoms in patients with lumbocrural pain. It was equivalent to traditional acupuncture,and there was no significant difference( P > 0. 05). Conclusions The pestle needle therapy is secure and effective in the treatment of lumbocrural pain,which is beneficial to relieve the clinical symptoms of patients with lumbocrural pain and should be widely promoted in clinical practice.
引文
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[15]刘泽恩,余洋,郑驰前,等.中药熏洗结合杵针治疗腰腿痛(寒湿证)疗效观察[J].四川中医,2015,33(9):112-113.
[16]陈日高,钟磊,董元蔚,等.杵针治疗气滞血瘀型腰腿痛的临床疗效观察[J].湖南中医药大学学报,2016,36(A01):43-44.
[17]刘栩豪,余洋,钟磊,等.应用TTM评价杵针治疗寒湿型腰腿痛的临床疗效研究[J].针灸临床杂志,2016,32(9):54-57.
[18]王鑫灵,陈日高.杵针治疗气滞血瘀型腰腿痛的远期疗效评价[J].成都中医药大学学报,2018,41(1):83-86.
[19]王平,李永春.针灸联合中药熏蒸辨治颈肩腰腿痛的临床观察[J].辽宁中医杂志,2016,43(9):1968-1971.
[20]赵永利.中医针灸综合治疗颈肩腰腿痛临床疗效观察[J].中国卫生标准管理,2018,9(10):96-97.
[21]刘晓玲,梁凡,王欣欣,等.杵针疗法的临床研究进展[J].四川中医,2015,33(7):190-191.
[2]安文博,姜劲挺.中医药治疗腰腿痛相关研究进展[J].中医药临床杂志,2012,24(5):485-486.
[3]宗园省.针灸治疗腰腿痛的作用机理及研究现状与进展[J].中医临床研究,2015,7(11):108-109.
[4]申治富,余思奕,胡幼平.杵针疗法的理论及临床运用[J].上海针灸杂志,2015,34(6):575-578.
[5]钟枢才,刘全让.李仲愚老先生的杵针疗法浅析[J].中医教育,1994,13(6):43,45.
[6]刘全让,钟枢才.李仲愚主任医师杵针疗法经验[J].成都中医药大学学报,1996,19(3):6-8.
[7]刘栩豪,余洋,钟磊,等.杵针腰阳关八阵、河车命强段治疗腰痹病31例[J].中国针灸,2016,36(3):295-298.
[8] Li Z,Yang KH,Mi DH,et al. The research about guidance of systematic review for clinical study[J].Cochrane Database Syst Rev,2012,2012(9Suppl):107.
[9] Hu Y,Li Z,Mi DH,et al. Chemoradiation combined with regional hyperthermia for advanced oesophageal cancer:a systematic review and meta-analysis[J]. J Clin Pharm Ther,2017,42(2):155-164.
[10] Li Z,Yang KH,Mi DH,et al. The method of exracting data from figure with software[J]. Cochrane Database Syst Rev,2012,2012(9Suppl):104.
[11] Li Z,Mi DH,Yang KH,et al. Comparison between Autocad and Draftsight in data extraction[J]. Cochrane Database Syst Rev,2013,2013(9Suppl):56.
[12]胡月,李征,曲雁,等.热疗综合疗法治疗原发性鼻咽癌的系统评价[J].循证医学,2015,15(2):96-101,107.
[13]胡月,李征,曲雁,等.胸腔化疗联合热疗治疗癌性胸腔积液有效性和安全性的Meta分析[J].中国全科医学,2017,20(32):4034-4041.
[14]刘栩豪,樊效鸿,钟磊,等.杵针为主治疗寒湿型腰腿痛疗效观察[J].上海针灸杂志,2015,34(9):876-879.
[15]刘泽恩,余洋,郑驰前,等.中药熏洗结合杵针治疗腰腿痛(寒湿证)疗效观察[J].四川中医,2015,33(9):112-113.
[16]陈日高,钟磊,董元蔚,等.杵针治疗气滞血瘀型腰腿痛的临床疗效观察[J].湖南中医药大学学报,2016,36(A01):43-44.
[17]刘栩豪,余洋,钟磊,等.应用TTM评价杵针治疗寒湿型腰腿痛的临床疗效研究[J].针灸临床杂志,2016,32(9):54-57.
[18]王鑫灵,陈日高.杵针治疗气滞血瘀型腰腿痛的远期疗效评价[J].成都中医药大学学报,2018,41(1):83-86.
[19]王平,李永春.针灸联合中药熏蒸辨治颈肩腰腿痛的临床观察[J].辽宁中医杂志,2016,43(9):1968-1971.
[20]赵永利.中医针灸综合治疗颈肩腰腿痛临床疗效观察[J].中国卫生标准管理,2018,9(10):96-97.
[21]刘晓玲,梁凡,王欣欣,等.杵针疗法的临床研究进展[J].四川中医,2015,33(7):190-191.