|
Meta analysis of efficacy and safety of pulling manipulation in the treatment of cervical spondylotic radiculopathy and evaluation of GRADE evidence level |
Hits 594 Download times 1919 Received:February 23, 2023 |
View Full Text View/Add Comment Download reader |
DOI
10.11656/j.issn.1672-1519.2023.05.15 |
Key Words
pulling manipulation;cervical spondylotic radiculopathy;Meta analysis;GRADE evaluation |
Author Name | Affiliation | E-mail | WANG Huaijing | First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China | | FU Bifeng | First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China Department of Orthopedics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Administration of Traditional Chinese Medicine Regional Orthopedics and Traumatology Diagnosis and Treatment Center, Tianjin 300381, China | | DING Shaojie | First Department of Acupuncture and Moxibustion, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin 300120, China | | LI Yuandong | First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China Department of Orthopedics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Administration of Traditional Chinese Medicine Regional Orthopedics and Traumatology Diagnosis and Treatment Center, Tianjin 300381, China | | YANG Guang | First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China Department of Orthopedics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Administration of Traditional Chinese Medicine Regional Orthopedics and Traumatology Diagnosis and Treatment Center, Tianjin 300381, China | | WANG Ping | First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China Department of Orthopedics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Administration of Traditional Chinese Medicine Regional Orthopedics and Traumatology Diagnosis and Treatment Center, Tianjin 300381, China | yfywangping@sina.com | FENG Minshan | Second Spine Department, Wangjing Hospital of China Academy of Chinese Medical Science, Beijing 100102, China | |
|
Abstract
|
[Objective] To systematically evaluate the clinical efficacy and safety of pulling manipulation in the treatment of cervical spondylotic radiculopathy.[Methods] From the establishment of the database to December 2021, the literature database (CNKI, Wanfang, VIP, CBM, PubMed, EMBASE, the Cochrane Library) was searched, and the literature data were extracted, the literature quality was evaluated with the improved Cochrane bias risk assessment tool, and revman5.3 meta analysis was made on the total clinical effective rate, visual analogue scale (VAS) score, Tanaka Jingjiu 35 point integral method, improvement rate of cervical spondylosis treatment score, auxiliary examination results and adverse reaction outcome indicators, publication bias analysis was made on the outcome indicators with the number of literature ≥10, and the evidence quality of the outcome indicators was evaluated by GRADE standard.[Results] The 17 studies were included, with a total sample size of 1 833, 927 cases in the experimental group and 906 cases in the control group. Meta analysis showed that the total clinical effective rate [RR=1.25, 95%CI(1.20, 1.31), P < 0.000 01], VAS score [WMD=-1.38, 95%CI(-1.90, -0.86), P < 0.000 01], Tanaka Jingjiu 35 point integral method [WMD=-2.72, 95%CI(-3.29, -2.15), P < 0.000 01], cervical spondylosis treatment score [SMD=1.09, 95%CI(0.58, 1.61), P < 0.000 1], auxiliary examination results [SMD=0.74, 95%CI(0.20, 1.28), P=0.008], adverse reactions [RR=0.48, 95%CI(0.21, 1.09), P=0.08]. In the total clinical efficiency, VAS score, Tanaka Jingjiu 35 point integral method, auxiliary examination results and cervical spondylosis treatment score, the curative effect of the manipulation group was better than that of the control group, and there was no significant difference in the number of adverse reactions.[Conclusion] Pulling manipulation can improve the clinical efficacy of cervical spondylotic radiculopathy, but there is no significant statistic difference in adverse reactions compared with traction. |
|
|
|
|
|
|