八段锦治疗神经根型颈椎病的系统评价与Meta分析

Effectiveness and safety of Baduanjin for acute cervical spondylotic radiculopathy：a systematic review

关键词:  八段锦  神经根型颈椎病  随机对照试验  系统评价  Meta分析

Key words:  Baduanjin  cervical spondylotic radiculopathy  randomized controlled trial  system evaluation  Meta-analysis

摘要:

[目的] 系统评价八段锦治疗神经根型颈椎病的临床疗效。[方法] 计算机检索中国知网数据库（CNKI）、维普资讯中文科技期刊数据库（VIP）、万方数据库（Wan-fang）、中国生物医学文献数据库（SinoMed）、Web of science、Clinical Trials gov、Pubmed、EMBASE、CENTRAL、Cochrane Library，查找出八段锦治疗神经根型颈椎病的随机对照试验（RCT），检索时限均从建库至2019年7月1日。两名研究者按照纳入与排除标准独立进行文献筛选、资料提取和偏倚风险评估，应用RevMan 5.3软件对最后纳入的研究进行Meta分析。[结果] 最终纳入10个RCT，共843例患者。Meta分析结果显示：八段锦+常规治疗与常规治疗比较，其临床疗效的总有效率差异具有统计学意义[OR=4.19，95% CI（2.42，7.26），P<0.000 01]；八段锦+常规治疗与常规治疗+颈部“米”字操比较，其临床疗效的总有效率差异具有统计学意义[OR=3.41，95% CI（1.56，7.46），P=0.002]；八段锦+常规治疗与常规治疗比较，其疼痛视觉模拟评分法（VAS）评分差异具有统计学意义[MD=-1.90，95% CI（-1.97，-1.83），P<0.000 01]。[结论] 基于现有的研究，该系统评价显示，与常规治疗相比，八段锦+常规治疗在临床疗效总有效率、VAS评分方面有一定的治疗优势。与常规治疗+颈部“米”字操比较，八段锦+常规治疗在临床疗效的总有效率方面有一定的治疗优势。但由于纳入研究的质量不高，仍需要大样本、多中心、随机、双盲试验及试验参照CONSORT标准和STRICTA声明进行RCT研究。

Abstract:

[Objective] To evaluate systematically the clinical efficacy of Baduanjin in the treatment of cervical spondylotic radiculopathy (CSR).[Methods] The collect randomized controlled trials (RCT) literatures of Baduanjin treating CSR from inception to 1 July 2019 from CNKI,Wanfang,VIP,SinoMed,Web of science,Clinical Trials gov,Pubmed,EMBASE.com,CENTRAL,Cochrane Library. Two investigators independently performed literature screening,data extraction,and risk assessment for bias according to inclusion and exclusion criteria,and RevMan 5.3 software was used to make the meta-analysis.[Results] A total of 10 RCTs involving 843 patients were included. There was significant difference in the total effective rate of clinical efficacy between the Baduanjin + conventional treatment group and the conventional treatment group[OR=4.19,95% CI (2.42,7.26)] (P<0.000 01). There was significant difference in the total effective rate of clinical efficacy between the Baduanjin + conventional treatment and the conventional treatment + neck "mi" operation[OR=3.41, 95% CI (1.56,7.46)] (P=0.002). There was significant difference in the VAS score of clinical efficacy between the Baduanjin + conventional treatment group and the conventional treatment group[MD=-1.90,95% CI (-1.97,-1.83)] (P<0.000 01).[Conclusion] Based on existing data and methods,the study showed that compared with conventional treatment,Baduanjin+conventional treatment has certain therapeutic advantages in terms of total clinical efficacy and VAS score. Compared with the conventional treatment + neck "mi" operation,Baduanjin + conventional treatment has certain therapeutic advantages in the total effective rate of clinical efficacy. However,due to the low quality of the included studies,large-scale,multicenter,randomized,double-blind trials and trials are still required to conduct randomized controlled trials with reference to the CONSORT standard and the STRICTA statement.