摘要
背景:腰椎间盘突出症是导致腰痛最常见的原因之一,给患者和社会带来了沉重的经济负担.对绝大部分患者而言,保守治疗是首选.中医药是保守治疗的重要组成部分,日益受到国际的关注.方法:组建多学科专家组成的工作组,通过系统文献检索和专家共识确定指南需解决的临床问题,采用GRADE方法对证据质量和推荐意见强度进行分级.结果:指南最终形成20条推荐意见,涉及身痛逐瘀汤、肾着汤、四妙散、独活寄生汤、腰痹通胶囊、腰痛宁胶囊、恒古骨伤愈合剂、手法、针刀、针刺、电针、中医传统功法(太极拳、八段锦、易筋经)及联合西医常规治疗.西医常规治疗包括非甾体抗炎药物、营养神经类药物、牵引等.结论:这是第一部严格按照国内外规范采用GRADE方法制订的中医药治疗腰椎间盘突出症的中医循证指南,希望指南中推荐意见可以帮助医护工作者更好地照护腰椎间盘突出症患者.
Abstract
Background:Lumbar disc herniation(LDH),as one of the most common causes of lower back pain,imposes a heavy economic burden on patients and society.Conservative management is the first-line choice for the majority of LDH patients.Traditional Chinese medicine(TCM)is an important part of conservative treatment and has attracted more and more international attention.Methods:We formed a guideline panel of multidisciplinary experts.The clinical questions were identified on the basis of a systematic literature search and a consensus meeting.We searched the literature for direct evidence on the management of LDH,and assessed its certainty generated recommendations using the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)approach.Results:The guideline panel made twenty recommendations,which covered use of Shentong Zhuyu Tang,Shenzhuo Tang,Simiao San,Duhuo Jisheng Tang,Yaobitong capsule,Yaotongning capsule,Henggu bone injury healing agent,manipulation,needle knife,acupuncture,electroacupuncture,Chinese exercise techniques(Tai Chi,Baduanjin,or Yijinjing)and integrative medicine,such as combined non-steroidal anti-inflammatory drugs,neural nutrition,and traction.Conclusion:This is the first LDH treatment guideline for TCM and integrative medicine with a systematic search,synthesis of evidence,and using the GRADE method to rate the quality of evidence.We hope these recommendations can help healthcare workers care for LDH patients.
基金项目
国家重点研发计划项目(2021YFC1712800)
国家重点研发计划项目(2021YFC1712803)
中国中医药循证能力提升项目(ZZ13-024-7)
国家中医药传承创新团队项目(ZYYCXTD-C-202003)
维普
万方数据