本文選題：針刀　切入點：第三腰椎橫突綜合征　出處：《成都中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的：采用系統(tǒng)評價Meta分析的方法評價針刀治療第三腰椎橫突綜合征的療效及安全性。方法：根據(jù)本次研究的納入以及排除標準,制定檢索策略,然后計算機檢索國內(nèi)數(shù)據(jù)庫CNKI、CNKI、維普數(shù)據(jù)庫、萬方會議論文數(shù)據(jù)庫、以及外文數(shù)據(jù)庫TheCochrane Library、PubMed數(shù)據(jù)庫、OVID數(shù)據(jù)庫。檢索時間為1990年到2015年11月。篩選出符合研究標準的隨機對照實驗研究,對納入研究的基本特征提取數(shù)據(jù)并制成excel表,并進行方法學質(zhì)量評價。對研究進行結(jié)局指標的定量和定性分析。結(jié)果：(1)本研究共納入11篇臨床隨機對照研究,其中治療組干預措施都是針刀,對照組采用非針刀的療法,包括5個封閉療法,3個針刺療法,2個電針療法,1個穴位注射療法,共納入881例符合L-3橫突綜合征診斷標準的的病例。經(jīng)統(tǒng)計納入的實驗的方法質(zhì)量學評價較低。(2)Meta分析結(jié)果示：①針刀組與針刺組臨床有效率比較結(jié)果[RR=1.05,95%CI(0.99,1.11)],臨床治愈率[RR=1.77,95%CI(1.37,2.29)],VAS疼痛評分[WMD=-0.90,95%CI(-1.21,-0.59)],ODI評分[WMD=3.20,95%CI(1.71,4.69)]；②針刀組與封閉組臨床有效率 比 較 結(jié) 果 [RR=1.04,95%CI(0.97,1.12)], 臨 床 治 愈 率[RR=1.71,95%CI(1.30,2.24)],VAS疼痛評分[WMD=-0.35,95%CI(-1.16,0.45)],ODI評分[WMD=-0.39,95%CI(-6.14,5.36)];③針刀組與電針組臨床有效率比較結(jié)果[RR=1.03,95%CI(0.98,1.08)],臨床治愈率[RR=1.72,95%CI(0.94,3.16)],VAS疼痛評分[WMD=-1.76,95%CI(-2.30,-1.22)]；④針刀組與穴位注射組臨床有效率比較結(jié)果[RR=1.11,95%CI(0.97,1.27)],臨床治愈率[RR=2.70,95%CI(1.61,4.54)]。 (3)敏感性分析的結(jié)論顯示Meta分析的結(jié)果較穩(wěn)定。結(jié)論：從研究結(jié)果中可以得到針刀對第三腰椎橫突綜合征的治療在臨床有效率、臨床治愈率、VAS疼痛評分、ODI評分方面是有一定優(yōu)勢的,但是由于證據(jù)質(zhì)量不高,結(jié)果需謹慎對待。
[Abstract]:Objective: to evaluate the efficacy and safety of needle knife in the treatment of the third lumbar transverse process syndrome by Meta analysis. Methods: according to the criteria of inclusion and exclusion of this study, the retrieval strategy was formulated. Then the computer retrieves the domestic database CNKI CNKI, the Weip database, the Wanfang Conference paper database, The retrieval time is from 1990 to November 2015. Random controlled experimental studies that meet the research criteria are selected, and the data are extracted from the basic features of the study and made into excel tables, and the foreign language database, TheCochrane Library and PubMed database, are obtained from the database, and the retrieval time is from 1990 to November 2015. The quantitative and qualitative analysis of the outcome index of the study was carried out. Results the study included 11 clinical randomized controlled studies, in which the intervention measures in the treatment group were all needle-knife, while the non-needle-knife therapy was used in the control group. Including 5 blocking therapy, 3 acupuncture therapy, 2 electroacupuncture therapy, 1 acupoint injection therapy, A total of 881 patients who met the diagnostic criteria for L-3 transverse process syndrome were included. The qualitative evaluation of the statistical method included in the experiment was lower. The results of meta-analysis showed that the clinical effective rate of the needle knife group was lower than that of the acupuncture group [RRN 1.0595 CI 0.991.11], and the clinical cure rate [RR1.77% 95CIV 1.37% 2.29] VAS. Pain score [WMD-0.90 ~ 95CI-1.21- 0.59] ODI score [WMD-3.2095 CI-1.714.69] [WMD-0.395 CI-1.714.69] [WMD-0.3995 CI-6.14365], [RRN1.04c95CI0.971.12], [RRN1.7195CI1.302.24] VAS pain score [WMD-0.3595CI-1.160.45] ODI score [WMD-0.3995CI-6.14365.The clinical efficacy of the scalpel group [RRR1.031.095 CI-6.14895] was compared with that of the electroacupuncture group [RRR31.095 CI-1.160.95]. VAS pain score [WMD-1.7695 CI-2.30U -1.22] the results of comparison of the clinical effective rate between the needle-knife group and the acupoint injection group [RRRRR1.11295 CI0.971.27], the clinical cure rate [RRR2.70 ~ 95CI1.61.1.4.54]. The sensitivity analysis showed that the results of Meta analysis were relatively stable. Conclusion: from the results of the study, we can get the needle knife to the third point. The treatment of lumbar transverse process syndrome is effective in clinic. There are some advantages in clinical cure rate and VAS pain score and ODI score, but due to the poor quality of evidence, the results need to be treated with caution.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.9

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