海南医科大学学报

目的:系统评价针灸治疗腰椎间盘突出症术后遗留疼痛的有效性与安全性,为其临床治疗提供依据。方法:计算机检索在2019年5月之前公开发表在PubMed、CBM、CNKI、万方、VIP、Embase、Cochrane图书馆中所有关于针灸治疗腰椎间盘突出症术后遗留疼痛的随机对照文献(RCT),然后应用RevMan5.3软件进行meta分析。结果:最终纳入11篇随机对照试验,共855例患者,其中试验组428例,对照组427例,比例1∶1;Meta分析结果:试验组在总体有效率[RR=1.22,95%CI(1.15,1.29),P<0.000 01]、视觉模拟疼痛(VAS)评分[MD=1.59,95%CI(1.22,1.95),P<0.000 01]、日本骨科协会评估治疗分数(JOA)[MD=5.66,95%CI(2.58,8.74),P=0.000 3]、不良发应发生率[RR=0.35,95%CI(0.18,0.71),P=0.003]均显著优于对照组,且差异均有统计学意义。结论:针灸在治疗腰椎间盘突出症术后遗留疼痛方面具有明显优势,可以显著缓解患者术后疼痛,提高生活质量。但本研究结论后期仍需纳入大样本、高质量文献进一步验证。

Objective: To systematically evaluate the effectiveness and safety of acupuncture in the treatment of postoperative residual pain in lumbar disc herniation, and to provide evidence for its clinical treatment. Methods: A randomized controlled trial(RCT) of all acupuncture treatments for postoperative lumbar disc herniation in PubMed, CBM, CNKI, Wanfang, VIP, Embase and Cochrane libraries was published by May 2019, followed by RevMan5.3 software for meta-analysis. Results: A total of 11 randomized controlled trials were included in 855 patients, including 428 in the experimental group and 427 in the control group, with a ratio of 1:1. The results of the meta-analysis showed that the overall effective rate of the experimental group [RR=1.22, 95% CI(1.15,1.29), P<0.001], visual analogue pain score [MD=1.59, 95% CI(1.22,1.95),P<0.001], Japanese Orthopaedic Association evaluation treatment score[MD=5.66, 95% CI(2.58,8.74), P<0.001], the incidence of adverse hair loss [RR=0.35, 95% CI(0.18,0.71),P<0.001] were significantly better than the control group, the difference was statistically significant. Conclusions: Acupuncture has obvious advantages in the treatment of residual pain after lumbar disc herniation, which can significantly relieve postoperative pain and improve quality of life. However, the conclusions of this study need to be further verified by the large sample and high quality literature.