Systematic Evaluation of Scraping Therapy for Pain Symptoms in Lumbar Disc Herniation and GRADE Evidence Quality Evidence
Objective To systematically evaluate the efficacy and safety of scraping therapy for pain symptoms in lumbar disc herniation(LDH).Methods Randomized controlled trials(RCTs)on scraping therapy for LDH were identified from databases of China National Knowledge Infrastructure Database(CNKI),WanFang Digital Journal(WanFang),China Science and Technology Journal Database(VIP),SinoMed,PubMed,Embase,Web of Science and The Cochrane Library from the establishment of databases to 29 August,2022.Articles were screened independently by two investigators,and the methodological quality of eligible studies was critically evaluated according to the Cochrane risk-of-bias tool for randomized trials(RoB2).Outcomes were analyzed by Review Manager 5.4 software.The quality of evidence was evaluated according to Grades of Recommendation,Assessment,Development and Evaluation(GRADE)standards.Results A total of 10 RCTs involving 1087 patients were analyzed through screening.Results of Meta-analysis demonstrated that patients who received scraping treatment showed significant improvement in the VAS score[MD=-1.11,95%CI(-1.58,-0.64),P<0.000 01],JOA score[MD=4.47,95%CI(3.76,5.17),P<0.000 01],the total effective rate[RR=1.13,95%CI(1.08,1.19),P<0.000 01]and patients'satisfaction with nursing[RR=1.21,95%CI(1.09,1.34),P=0.000 5]when compared to those in the control group(P<0.000 01).The quality of evidence for outcomes measured was very low.Conclusion Existing evidence shows that scraping treatment can alleviate patients'pain,and increase their satisfaction with clinical nursing.However,given the low quality of evidence,the clinical evidence must be further validated by rigorous multi-center,large-sample RCTs.
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