目的:针对冲击波治疗腰椎间盘突出症(LumbarDisc Herniation,LDH)的临床疗效进行系统评价.方法:检索国内外数据库资源中以冲击波疗法为主要干预措施治疗LDH的随机对照试验研究,针对符合纳入标准的研究进行质量评价,并采用Review Manager 5.3软件进行Meta分析.结果:纳入研究9项,涉及病例807例,Meta分析显示:①采用冲击波治疗组与推拿、功能锻炼对照组相比,临床有效率[相对危险度(RR)=1.25,95％置信区间(CI)(1.13,1.39),P＜0.000 01]的差异有统计学意义;②视觉模拟评分法(Visual Analogue Scale,VAS)评分亚组分析结果显示:冲击波与中频电疗、牵引、药物相比,均数差(MD)=-1.49,95％CI(-1.86,-1.12),P＜0.000 01)],差异有统计学意义."冲击波+综合理疗(功能锻炼、理疗、推拿、针灸、牵引、超声波和药物)VS综合理疗(功能锻炼、理疗、推拿、针灸、牵引、超声波和药物)"结果显示(MD=-1.51,95％CI[-1.94,-1.07]),P＜0.000 01),差异有统计学意义.③日本骨科协会评估治疗分数(Japanese Orthopaedic Associa-tion,JOA)评分分析结果显示,冲击波组与对照组治疗后JOA评分(MD=3.83,95％CI[3.61,4.06],P＜0.000 01)的差异有统计学意义.④Oswestry功能障碍指数问卷表(Oswestry Disability Index,ODI)评分分析结果示,冲击波组与对照组ODI评分(MD=-2.81,95％CI[-6.64,1.02],P=0.15)的差异无统计学意义.⑤36项简明健康状况调查量表(The Mos 36-item Short From Health Survey,SF-36)评分结果显示,冲击波组与对照组 SF-36 评分(MD=11.46,95％CI[8.78,14.14],P＜0.00001)的差异有统计学意义.结论:纳入研究分析结果提示,以冲击波疗法为主配合相应疗法对LDH的疗效可靠,可望通过后续更多大样本随机对照试验研究的实施加以佐证,为LDH临床治疗方法的选择提供新的参考依据.
A Meta-analysis of the effect of shockwave therapy on lumbar disc herniation
Objective:In view of the shock waves(LDH)in treatment of lumbar intervertebral disc protrusion clinical curative effect evaluation system.Methods:to retrieve database resources at home and abroad in order to rush.In 9 cases,807 cases involved,Meta analysis showed that:① by shock wave treatment group and the massage,functional exercise control group,by shock waves([RR=1.25,95％CI(1.13,1.39),P＜0.000 01]);(2)VAS score subgroup analysis results show that the shock wave compared with medium frequency electrotherapy,traction,drugs"(MD=-1.49,95％CI[-1.86,-1.12],P＜0.00001),The difference was statistically significant.③ JOA score analysis results show that the shock wave group and control group after treatment,(MD=3.83,95％CI[3.61,4.06],P＜0.000 01),The difference was statistically significant.④ ODI score analysis result,the shock wave group and the control group,(MD=-2.81,95％CI[-6.64,1.02],P=0.15),The difference was statistically significant.⑤ SF-36 quality evaluation score structure showed that shock wave group and the control group,(MD=11.46,95％CI[8.78,14.14],P＜0.000 01),The difference was statistically significant.Funnel chart analysis showed that in the literature may be potential publication bias.Conclusion:included in the analysis of research results suggest,give priority to with shock wave therapy combined with corresponding to cooperate.
万方数据
维普
