海南医科大学学报

目的：运用贝叶斯网状Meta分析评价中医方法（针灸、推拿、针刀、中药、牵引）联合神经阻滞治疗腰椎间盘突出症的临床疗效。方法：检索知网、万方、维普、中国生物医学文献库、Pubmed、Web of science、The Cochrance Library数据库中医方法联合神经阻滞治疗腰椎间盘突出症的随机对照研究，检索时间为各库建库至2021年5月。2位研究员独立按照制定的纳排标准对文献进行筛选。采用R、RStudio、addis-1.16.6软件进行贝叶斯模型网状Meta分析。结果：最终纳入27篇文献，共计2 074例受试者，涉及6种干预措施，分别为单纯神经阻滞、中药联合神经阻滞、针灸联合神经阻滞、针刀联合神经阻滞、牵引联合神经阻滞、推拿联合神经阻滞。网状分析结果显示：（1）在有效率上，除牵引联合神经阻滞外，其它干预措施均优于单纯神经阻滞，针灸、针刀、推拿、中药分别联合神经阻滞优于牵引联合神经阻滞，概率排在第一位的为针灸联合神经阻滞。（2）在VAS评分上，除牵引联合神经阻滞外，其它干预措施优于单纯神经阻滞，中药、推拿、针刀分别联合神经阻滞优于牵引联合神经阻滞，概率排序排结果最优的干预措施为中药联合神经阻滞。（3）在JOA评分上，两两干预措施之间比较无统计差异，概率排序第一的为中药联合神经阻滞。结论：中医疗法联合神经阻滞优于单纯神经阻滞，中药联合神经阻滞和针灸联合神经阻滞措施在治疗LDH疗效较好，牵引联合神经阻滞疗效较差。

Objective: To evaluate the clinical efficacy of Chinese medicine methods(acupuncture, tui na, acupuncture knife, traditional Chinese medicine, traction) combined with nerve block treatment for lumbar disc herniation using Bayesian mesh Meta-analysis.Methods: Randomized controlled studies of TCM methods combined with nerve block for lumbar disc herniation in CNKI, Wanfang, Vip, China Biomedical Literature Library, Pubmed, Web of science, and The Cochrance Library databases were searched for the period from the establishment of each database to May 2021. 2 researchers independently followed the developed nerf criteria to Screening was performed. Bayesian model mesh Meta-analysis was performed using R, RStudio, and addis-1.16.6 software.Results: Twenty-seven papers with a total of 2074 subjects were finally included, involving six interventions, namely nerve block alone, herbal medicine combined with nerve block, acupuncture combined with nerve block, acupuncture combined with nerve block, traction combined with nerve block, and tui na combined with nerve block. The results of the net analysis showed that(1)in terms of efficiency, all interventions were better than simple nerve block except for traction combined nerve block, and acupuncture, acupuncture, tui-na and Chinese medicine combined nerve block were better than traction combined nerve block respectively, and the probability ranked first for acupuncture combined nerve block.(2) On the VAS score, except for traction combined with nerve block, other interventions were superior to simple nerve block, and the combination of herbal medicine, acupuncture, and acupuncture respectively was superior to traction combined with nerve block, and the intervention with the best probability ranking result was herbal medicine combined with nerve block.(3)There was no statistical difference between the two interventions compared in terms of JOA scores, and the probability ranked first for herbal medicine combined nerve block.Conclusion: Chinese medicine combined nerve block was superior to nerve block alone, and Chinese medicine combined nerve block and acupuncture combined nerve block measures were more effective in the treatment of LDH, and traction combined nerve block was less effective.