發(fā)布時間：2018-01-13 11:58

  本文關鍵詞：中藥蒸汽浴治療腰椎間盤突出癥臨床療效的Meta分析　出處：《遼寧中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

  更多相關文章： 腰椎間盤突出癥 中藥蒸汽浴 系統(tǒng)評價 Meta分析

【摘要】：目的:探究中藥蒸汽浴結(jié)合其他療法治療腰椎間盤突出癥的臨床療效。方法:由2名系統(tǒng)評價員提取檢索關鍵詞,科學設計有效的文獻檢索策略,運用計算機檢索從中國知網(wǎng)(CNKI)、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)、維普數(shù)據(jù)庫(VIP)和萬方數(shù)字化期刊群(WF)中檢索從各數(shù)據(jù)庫的建庫日期至2015年8月為止的文獻;所納入文獻以中藥蒸汽浴或中藥蒸汽浴療法為主結(jié)合其他療法治療腰椎間盤突出癥為治療組,以對應的其他方法治療治療腰椎間盤突出癥為對照組的隨機對照試驗,確定納入標準和排除標準,納入符合標準的文獻69篇。運用“Cochrane偏倚評價表”對納入研究進行風險治療評估,并運用Revman5.3軟件分析收集到的數(shù)據(jù)。亞組分析是根據(jù)結(jié)合的不同外治法分組,觀察指標分析根據(jù)治療的有效率和VAS評分進行分析。此外,創(chuàng)建漏斗圖分析潛在的發(fā)表偏倚。結(jié)果:研究共計8800名參與者參加,治療組患者共計4613名,對照組患者共計4222名。結(jié)果表明,蒸汽浴療法作為治療組治療腰椎間盤突出癥的治療有效率大于其它療法作為對照組的治療有效率(OR=5.19,95%Cl:4.44,6.06)。此外,本研究將蒸汽浴結(jié)合其他外治法分成了4個亞組,且治療有效率均高于單獨使用該外治法,“牽引”亞組(OR=6.73,95%CI4.84,9.37);“推拿”亞組(OR=4.36,95%CI2.86,6.66);“針刺”亞組(OR=5.19,95%CI2.46,10.97);“推拿針刺”亞組(OR=4.85,95%CI2.878.20)。觀察指標VAS評分分析顯示結(jié)果(WMD=-1.26,95%CI-1.37,-1.16)。漏斗圖形幾乎是對稱的,說明偏倚風險小。結(jié)論:中藥蒸汽浴療法治療腰椎間盤突出癥的有效率優(yōu)于其他療法;亞組結(jié)果表明中藥蒸汽浴分別結(jié)合“牽引”、“推拿”、“針刺”、“推拿針刺”治療療效優(yōu)于單純采用“牽引”、“推拿”、“針刺”、“推拿針刺”治療;中藥蒸汽浴治療能明顯降低腰椎間盤突出癥患者VAS評分。同時需要提供更多大規(guī)模和高質(zhì)量隨機對照試驗,進而與其他療法驗證比較尚能明確優(yōu)劣。
[Abstract]:Objective: to explore the clinical efficacy of steam bath combined with other therapies in the treatment of lumbar disc herniation. Methods: the key words were extracted by two systematic evaluators and an effective literature retrieval strategy was designed scientifically. A computer search was carried out from CNKI, China Biomedical Literature Database (CBM). VIP (WIP) and WF (Digital Journal Group of Wanfang) were used to search the literature from the date of establishment of each database until August 2015. Included in the literature with traditional Chinese medicine steam bath or traditional Chinese medicine steam bath therapy combined with other therapies for the treatment of lumbar disc herniation as the treatment group. To treat lumbar disc herniation with corresponding other methods as the control group of randomized controlled trials, to determine the inclusion criteria and exclusion criteria. A total of 69 articles were included to meet the criteria. The risk treatment assessment of the inclusion study was conducted using the Cochrane bias Evaluation form. Revman5.3 software was used to analyze the collected data. The subgroup analysis was based on the combination of different external treatment methods, the observation indicators were analyzed according to the effective rate of treatment and the VAS score. In addition, the subgroup analysis was carried out according to the effective rate of treatment and the VAS score. Results: the study included 8,800 participants, 4613 patients in the treatment group and 4222 patients in the control group. The effective rate of steam bath therapy in treating lumbar disc herniation in treatment group was higher than that in other treatments as control group. In addition, this study divided steam bath and other external therapy into 4 subgroups, and the effective rate of treatment was higher than that of using the external therapy alone, and the "traction" subgroup was 6.73. 95 CI4.84 / 9.37; The "massage" subgroup was 4.36 ~ 95 CI 2.86 ~ 6.66; The "Acupuncture" subgroup was 5.19 ~ 95% CI 2.46 ~ 10.97%; The observation index VAS score analysis showed that WMD-1.2695 CI-1.37. The funnel pattern was almost symmetrical, indicating that the risk of bias was small. Conclusion: the effective rate of steam bath therapy for lumbar disc herniation is better than other treatments. The results of subgroup showed that the effect of steam bath combined with "traction", "massage", "acupuncture" and "massage acupuncture" was better than that of "traction", "massage", "acupuncture" and "massage acupuncture". Chinese medicine steam bath treatment can significantly reduce the VAS score of patients with lumbar disc herniation. At the same time, it needs to provide more large-scale and high-quality randomized controlled trials, and then compared with other therapies to verify the advantages and disadvantages.
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R274.9
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本文編號：1418793