[1]许金海,杨爱民,施问民,等.活血化瘀类中药治疗神经根型颈椎病有效性和安全性的系统评价[J].中医正骨,2019,31(12):20-28.
 XU Jinhai,YANG Aimin,SHI Wenmin,et al.Clinical efficacy and safety of blood act stasis remov drugs for treatment of cervical spondylotic radiculopathy:a systematic review[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(12):20-28.
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活血化瘀类中药治疗神经根型颈椎病有效性和安全性的系统评价()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期数:
2019年12期
页码:
20-28
栏目:
文献研究
出版日期:
2019-12-20

文章信息/Info

Title:
Clinical efficacy and safety of blood act stasis remov drugs for treatment of cervical spondylotic radiculopathy:a systematic review
作者:
许金海1杨爱民2施问民2王晶1王国栋1周晓宁1匡昱林1乔娇娇1叶洁1莫文1施杞1
(1.上海中医药大学附属龙华医院,上海 200032; 2.上海市浦东新区浦南医院,上海 200125)
Author(s):
XU Jinhai1YANG Aimin2SHI Wenmin2WANG Jing1WANG Guodong1ZHOU Xiaoning1KUANG Yulin1QIAO Jiaojiao1YE Jie 1MO Wen1SHI Qi1
1.Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China2.Shanghai Punan Hospital of Pudong New District,Shanghai 200125,China
关键词:
活血祛瘀药 神经根型颈椎病 Meta分析 系统评价
Keywords:
blood act stasis remov drugs cervical spondylotic radiculopathy meta-analysis systematic review
摘要:
目的:系统评价活血化瘀类中药治疗神经根型颈椎病(cervical spondylotic radiculopathy,CSR)的有效性和安全性。方法:计算机检索Cochrane Library、PubMed、EMbase、CNKI、万方数据库、维普全文期刊数据库、中国生物医学文献光盘数据库,检索年限均设定为建库至 2019年1月31日。对纳入的文献进行方法学质量评估并提取有效数据,采用Revman5.3软件进行Meta分析。结果:系统评价共纳入41篇文献,涉及4079例受试者。Meta分析结果显示,活血化瘀类中药治疗CSR的总有效率高于西药治疗[I2=0%,OR=2.90,95%CI(1.98,4.26)]; 活血化瘀类中药结合非药物疗法治疗CSR的总有效率高于非药物疗法[I2=0%,OR=4.13,95%CI(2.97,5.75)]; 活血化瘀类中药治疗CSR的治愈率高于西药治疗[I2=27%,OR=2.32,95%CI(1.67,3.24)]; 活血化瘀类中药结合非药物疗法治疗CSR的治愈率高于非药物疗法[I2=0%,OR=2.38,95%CI(1.85,3.07)]; 活血化瘀类中药治疗CSR的治疗后疼痛视觉模拟量表(visual analogue scale,VAS)评分低于安慰剂治疗[I2=87%,MD=-13.56,95%CI(-22.44,-4.68)]; 活血化瘀类中药与西药治疗CSR的治疗后疼痛VAS评分差异无统计学意义[I2=76%,MD=-0.33,95%CI(-0.89,-0.23)]; 活血化瘀类中药结合非药物疗法治疗CSR的治疗后疼痛VAS评分低于非药物疗法[I2=96%,MD=-1.38,95%CI(-1.92,-0.84)]; 活血化瘀类中药治疗CSR的治疗后颈椎功能障碍指数(neck disability index,NDI)低于安慰剂治疗[I2=0%,MD=-3.26,95%CI(-4.96,-1.55)]; 活血化瘀类中药与西药治疗CSR的治疗后神经根型颈椎病疗效评分差异无统计学意义[I2=95%,OR=0.96,95%CI(-0.65,2.57)]。活血化瘀类中药造成的不良反应较轻,且少于消炎止痛类西药。结论:现有证据表明,活血化瘀类中药治疗CSR总体疗效较好,且较为安全。
Abstract:
Objective:To systematically review the clinical efficacy and safety of blood act stasis remov drugs for treatment of cervical spondylotic radiculopathy(CSR).Methods:The articles included from database establishing to January 31,2019 were retrieved from Cochrane Library,PubMed,EMbase,CNKI,WanFang Database,Vip database and CBMdisc through computer.The methodological quality of research in the articles was evaluated and the valid data were extracted and a Meta-analysis was conducted by using Revman5.3 software.Results:Forty-one articles(4079 patients)were included in the final analysis.The results of Meta-analysis demonstrated that the total effective rate was higher in patients who received blood act stasis remov drugs compared to patients who received western medicine and was higher in patients who received combination of blood act stasis remov drugs with non-drug therapy compared to patients who received non-drug therapy for treatment of CSR(I2=0%,OR=2.90,95%CI(1.98,4.26); I2=0%,OR=4.13,95%CI(2.97,5.75)).The cure rate was higher in patients who received blood act stasis remov drugs compared to patients who received western medicine and was higher in patients who received combination of blood act stasis remov drugs with non-drug therapy compared to patients who received non-drug therapy for treatment of CSR(I2=27%,OR=2.32,95%CI(1.67,3.24; I2=0%,OR=2.38,95%CI(1.85,3.07)).The posttreatment pain visual analogue scale(VAS)scores were lower in patients who received blood act stasis remov drugs compared to patients who received placebo for treatment of CSR(I2=87%,MD=-13.56,95%CI(-22.44,-4.68)).There was no statistical difference in posttreatment pain VAS scores between patients who received blood act stasis remov drugs and patients who received western medicine for treatment of CSR(I2=76%,MD=-0.33,95%CI(-0.89,-0.23)).The posttreatment pain VAS scores were lower in patients who received combination of blood act stasis remov drugs with non-drug therapy compared to patients who received non-drug therapy for treatment of CSR(I2=96%,MD=-1.38,95%CI(-1.92,-0.84)).The posttreatment neck disability index(NDI)was lower in patients who received blood act stasis remov drugs compared to patients who received placebo for treatment of CSR(I2=0%,MD=-3.26,95%CI(-4.96,-1.55)).There was no statistical difference in posttreatment efficacy scores between patients who received blood act stasis remov drugs and patients who received western medicine for treatment of CSR(I2=95%,OR=0.96,95%CI(-0.65,2.57)).The adverse reactions caused by blood act stasis remov drugs were slighter and less than those caused by analgesics anti-inflammatory.Conclusion:Available evidence suggests that blood act stasis remov drugs are effective and safe for treatment of CSR.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81603635); 上海市科学技术委员会科研计划项目(17401934400,19401901100); 上海申康医院发展中心项目(16CR4011A); 上海市进一步加快中医药事业发展三年行动计划项目 [ZY(2018-2020)-FWTX-4002]通讯作者:莫文 E-mail:mw2218@126.com(收稿日期:2019-10-13 本文编辑:李晓乐)
更新日期/Last Update: 2019-12-15