腰痹通胶囊联合手法治疗中老年腰椎间盘突出症疗效与安全性的Meta分析

Meta-analysis on the effectiveness and safety of Yaobitong capsules combined with manipulation for treating lumbar disc herniation in middle-aged and elderly patients

关键词:  腰痹通胶囊  手法治疗  腰椎间盘突出症  随机对照研究  Meta分析  中老年人群

Key words:  Yaobitong capsules  manipulation  lumbar disc herniation  randomized controlled trial  meta-analysis  middle-aged and elderly population

摘要:

[目的] 系统评价腰痹通胶囊联合手法治疗中老年腰椎间盘突出症的疗效。[方法] 系统检索国内外8个数据库，由两名研究者独立完成文献检索、筛选、数据提取及质量评估。文献质量采用Cochrane协作网提供的偏倚风险工具（ROB2）进行评价，Meta分析使用RevMan 5.3软件。[结果] 共检索到295篇文献，最终纳入6项研究（中文随机对照试验），共702例患者。Meta分析结果显示，腰痹通胶囊联合手法治疗中老年腰椎间盘突出症在提升总有效率[RR=1.20，95%CI（1.13，1.28），P<0.000 01]、降低VAS评分[MD=-1.63，95%CI（-2.08，-1.17），P<0.000 01]、减少白细胞介素-8（IL-8）水平[SMD=-1.25，95%CI（-1.47，-1.03），P<0.000 01]及降低不良事件发生率[RR=0.16，95%CI（0.06，0.45），P=0.000 05]方面均具优势。而在改善白细胞介素-6（IL-6）水平[SMD=-0.87，95%CI（-1.89，0.14），P=0.09]方面，与对照组差异无统计学意义（P>0.05）。[结论] 腰痹通胶囊联合手法治疗中老年LDH相较于非甾体抗炎药物（NSAIDs）联合手法，可提升临床疗效，减少不良反应，并降低血清炎性因子水平。然而，本研究的局限性影响了结果的可靠性，仍需更多高质量、多中心研究进一步验证。

Abstract:

[Objective] To systematically evaluate the therapeutic effect of Yaobitong capsules combined with manipulative therapy in the treatment of lumbar disc herniation(LDH) in middle-aged and elderly patients.[Methods] The system searches 8 national and international databases,and two researchers independently perform the literature search,screening,data extraction and quality assessment. The quality of the literature was assessed using the Cochrane Collaboration's risk of bias tool(ROB2). Meta-analyses were performed using RevMan 5.3 software.[Results] A total of 295 articles were retrieved and finally 6 studies(Chinese randomised controlled trials) with a total of 702 patients were included. The meta-analysis results showed Yaobitong capsules combined with manipulation in the treatment of middle-aged and elderly patients with lumbar disc herniation had advantages in improving the overall efficacy rate[RR=1.20,95%CI(1.13,1.28),P<0.000 01],reducing the VAS scores[MD=-1.63, 95%CI(-2.08,-1.17),P<0.000 01],reduction in interleukin-8(IL-8) levels[SMD=-1.25,95%CI(-1.47,-1.03),P<0.000 01],and reduction in the incidence of adverse events[RR=0.16,95%CI(0.06,0.45),P=0.000 05]. There was no significant difference in the improvement of interleukin-6(IL-6) levels[SMD=-0.87,95%CI(-1.89,0.14),P=0.09] between the two groups(P>0.05).[Conclusion] Compared with NSAIDs combined with manipulation,Yaobitong capsules combined with manipulation in the treatment of LDH in middle-aged and elderly people can improve clinical efficacy,reduce adverse effects,and reduce the level of serum inflammatory factors. However,the limitations of this study affect the reliability of the results,and more high-quality multicentre studies are needed for further verification.