口服中成药联合常规西药治疗腰椎间盘突出症有效性和安全性的网状Meta分析

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中文摘要：目的系统评价不同口服中成药联合常规西药治疗腰椎间盘突出(LDH)的有效性和安全性。方法计算机检索PubMed、Embase、Cochrane Library、Medline、CNKI、WanFang Data、VIP和SinoMed数据库，搜集关于口服中成药联合常规西药治疗LDH的随机对照试验(RCT)，检索时限均从建库至2023年4月10日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用Stata 17。0及RevMan 5。4软件进行网状Meta分析。结果共纳入26个RCT，涉及16种中成药，总样本量2 448例。网状Meta分析结果显示，共13种中成药联合常规西药治疗效果优于单纯常规西药治疗，其中在改善疼痛视觉模拟量表(VAS)评分方面，排名前三的干预措施为颈腰康胶囊+常规西药＞腰痹通胶囊+常规西药＞活血止痛胶囊+常规西药;在改善日本骨科协会(JOA)评分方面，排名前三的干预措施为祛风止痛胶囊+常规西药＞腰痹通胶囊+常规西药＞鹿川活络胶囊+常规西药;在临床有效率方面，排名前三的干预措施为鹿川活络胶囊+常规西药＞仙灵骨葆胶囊+常规西药＞通滞苏润江胶囊+常规西药;安全性方面，各项研究均未发生严重药品不良反应，口服中成药联合常规西药整体药品不良反应发生率较低。结论现有证据表明，口服中成药联合常规西药治疗LDH可提高临床疗效，其中腰痹通胶囊在降低VAS评分、改善JOA评分以及提高临床有效率方面均有优势。受纳入研究数量和质量限制，上述结论有待更多高质量的研究予以验证。

外文标题：Efficacy and safety of oral Chinese patent medicines combined with conventional western medicines in the treatment of lumbar disc herniation:a network Meta-analysis

外文摘要：Objective To systematically review the efficacy and safety of different oral Chinese patent medicines combined with conventional western medicines in the therapy of lumbar disc herniation(LDH).Methods PubMed,Embase,Cochrane Library,Medline,CNKI,WanFang data,VIP and SinoMed databases were electronically searched to collect randomized clinical trials(RCTs)on oral Chinese patent medicines combined with conventional western medicines in the treatment of LDH from the inception to April 10,2023.Two reviewers independently screened the literature,extracted data,and evaluated the risk of bias of included studies.Network Meta-analysis was then performed by Stata 17.0 and RevMan 5.4 softwares.Results A total of 26 RCTs were included,involving 16 Chinese patent medicines with a total sample size of 2 448 cases.The network Meta-analysis results showed that 13 Chinese patent medicines combined with conventional western medicines had better effects than conventional western medicines alone.Among them,in terms of a better VAS score,the top three interventions were Jingyaokang capsules+conventional western medicine＞Yaobitong capsules+conventional western medicine＞Huoxue Zhitong capsules+conventional western medicine;in terms of a better Japanese Orthopaedic Associationl(JOA)score,the top three interventions were Qufeng Zhitong capsules+conventional western medicine＞Yaobitong capsules+conventional western medicine＞Luchuan Huoluo capsules+conventional western medicine;in terms of the clinical effective rate,the top three interventions were Luchuan Huoluo capsules+conventional western medicine＞Xianling Gubao capsules+conventional western medicine＞Tongzhi Surunjiang capsules+conventional western medicine;in terms of safety,no serious adverse drug reactions occurred in all studies,and the overall incidence of adverse drug reactions in the oral Chinese patent medicines combined with conventional western medicines group was lower than that in the conventional western medicines group.Conclusion The combination of oral Chinese patent medicines and conventional western medicines has been shown to improve the clinical efficacy of LDH.Among these,Yaobitong capsules stand out for its ability to reduce VAS score,improve JOA score ranking,and increase the effective rate.Due to limited quality and quantity of the included studies,more high-quality studies are required to verify the above conclusions.

外文关键词：

Chinese patent medicineLumbar disc herniationNetwork Meta-analysisRandomized clinical trial

作者：

任我行、丁立鹏、陆洁航、葛海雅、刘永铭、汪正明、詹红生

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作者单位：

上海中医药大学附属曙光医院石氏伤科医学中心(上海 201203)

上海市中医药研究院骨伤科研究所(上海 201203)

关键词：

中成药腰椎间盘突出症网状Meta分析随机对照试验

基金：

国家自然科学基金面上项目国家自然科学基金面上项目国家自然科学基金面上项目上海市慢性筋骨病临床医学研究中心项目上海申康医院发展中心临床三年行动计划资助詹红生全国名老中医药专家传承工作室建设项目上海高水平地方高校"慢性筋骨病损研究与转化"创新团队

项目编号：

81973871821744038207446620MC1920600SHDC2020CR1051B国中医药人教函[2022]75号沪教委人[2022]3号

出版年：

2024

DOI：

10.12173/j.issn.1005-0698.202401032

药物流行病学杂志

中国药学会武汉医药（集团）股份有限公司

药物流行病学杂志

CSTPCD

影响因子：0.746

ISSN：1005-0698

年,卷(期)：2024.33(6)