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　WU Zhuotan,REN Xiaoping,LAN Rongyu,et al.Clinical outcomes of promoting blood circulation and removing blood stasis Chinese patent drugs for adjuvant treatment of cervical spondylotic radiculopathy:a network meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(01):33-42.
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活血化瘀类中成药辅助治疗神经根型颈椎病有效性的网状Meta分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期数:
2024年01期
页码:
33-42
栏目:
文献研究
出版日期:
2024-01-20

文章信息/Info

Title:
Clinical outcomes of promoting blood circulation and removing blood stasis Chinese patent drugs for adjuvant treatment of cervical spondylotic radiculopathy:a network meta-analysis
作者:
吴卓檀1; 任晓平2; 兰荣玉2; 张卫华2; 申婷婷1; 韩林轩2; 吴晓飞2; 杨汉立1
1.广西中医药大学研究生院,广西 南宁 530001; 2.广西中医药大学附属瑞康医院,广西 南宁 530011
Author(s):
WU Zhuotan1; REN Xiaoping2; LAN Rongyu2; ZHANG Weihua2; SHEN Tingting1; HAN Linxuan2; WU Xiaofei2; YANG Hanli1
1.Postgraduate College of Guangxi University of Chinese Medicine,Nanning 530001,Guangxi,China 2.Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530011,Guangxi,China
关键词:
颈椎病;  神经根病;  活血祛瘀;  中成药;  网络Meta分析
Keywords:
cervical spondylosis;  radiculopathy;  promoting blood circulation for removing blood stasis;  Chinese patent drugs;  network meta-analysis
摘要:
目的:系统评价不同活血化瘀类中成药辅助治疗神经根型颈椎病(cervical spondylotic radiculopathy,CSR)的临床疗效。方法:应用计算机检索中国知网、维普网、万方数据库、PubMed、Web of Science和Cochrane Library中关于活血化瘀类中成药辅助治疗CSR的随机对照试验,检索时限均为建库至2023年9月20日。对照组单纯采用常规非手术方法治疗,试验组在对照组的基础上联合活血化瘀类中成药口服治疗。依据文献检索及筛选方案筛选出符合要求的文献后,由2名研究人员分别独立进行数据提取和质量评价。采用Stata18.0软件绘制网状关系图,对治疗有效率、颈部疼痛视觉模拟量表(visual analogue scale,VAS)评分、颈椎功能障碍指数(neck disability index,NDI)进行网状Meta分析,并根据累计概率排名曲线下面积(the surface under the cumulative ranking curve,SUCRA)对治疗方法的疗效进行排序。采用比较-校正漏斗图进行发表偏倚检验。结果:共检索到6768篇文献,通过逐层筛选最终纳入28篇文献,涉及颈痛颗粒、颈舒颗粒、脊痛消胶囊、痹祺胶囊、舒筋通络颗粒、颈复康颗粒共6种活血化瘀类中成药。网状Meta分析结果显示,在治疗有效率方面,不同活血化瘀类中成药辅助治疗CSR的疗效排序为颈痛颗粒联合常规治疗(SUCRA=78.4%)>痹祺胶囊联合常规治疗(SUCRA=71.6%)>颈舒颗粒联合常规治疗(SUCRA=62.1%)>舒筋通络颗粒联合常规治疗(SUCRA=53.7%)>脊痛消胶囊联合常规治疗(SUCRA=43.3%)>颈复康颗粒联合常规治疗(SUCRA=40.5%)>常规治疗(SUCRA=0.4%); 在颈部疼痛VAS评分方面,不同活血化瘀类中成药辅助治疗CSR的疗效排序为舒筋通络颗粒联合常规治疗(SUCRA=96.3%)>痹祺胶囊联合常规治疗(SUCRA=86.2%)>颈复康颗粒联合常规治疗(SUCRA=51.6%)>颈痛颗粒联合常规治疗(SUCRA=50.8%)>颈舒颗粒联合常规治疗(SUCRA=37.4%)>脊痛消胶囊联合常规治疗(SUCRA=27.4%)>常规治疗(SUCRA=0.4%); 在NDI方面,不同活血化瘀类中成药辅助治疗CSR的疗效排序为痹祺胶囊联合常规治疗(SUCRA=95%)>颈复康颗粒联合常规治疗(SUCRA=71.3%)>颈痛颗粒联合常规治疗(SUCRA=69.2%)>脊痛消胶囊联合常规治疗(SUCRA=38.7%)>颈舒颗粒联合常规治疗(SUCRA=20.8%)>常规治疗(SUCRA=5.0%)。结论:现有的证据表明,颈痛颗粒辅助治疗CSR的综合疗效最佳,舒筋通络颗粒在缓解颈部疼痛方面效果最佳,痹祺颗粒在改善颈椎功能方面效果最佳。但由于对照组采用的非手术疗法不尽相同及文献数量、质量等的限制,本研究的结论尚需进一步验证。
Abstract:
Objective:To systematically review the clinical outcomes of different Chinese patent drugs for promoting blood circulation and removing blood stasis in adjuvant treatment of cervical spondylotic radiculopathy(CSR).Methods:All the randomized controlled trial(RCT)articles about promoting blood circulation and removing blood stasis Chinese patent drugs for adjuvant treatment of CSR included from database establishing to September 20,2023 were retrieved from the China National Knowledge Internet,Vip Database,Wanfang Database,PubMed,Web of Science and Cochrane Library through computer.The patients in experiment group were treated with conventional non-surgical therapies and oral application of Chinese patent drugs for promoting blood circulation and removing blood stasis,while the ones in control group with conventional non-surgical therapies alone.The articles were screened according to the retrieval and screening scheme.The information was extracted and the methodological quality of included researches in the articles was evaluated independently by two researchers.The reticulation plots were drawn by using Stata18.0 software,and then a reticulated Meta-analysis on clinical effective rate,neck pain visual analogue scale(VAS)score,and neck disability index(NDI)was conducted; Furthermore,the outcomes of the therapies were ranked according to the surface under the cumulative ranking curve(SUCRA),and the publication bias was tested by using comparison-correction funnel plots.Results:Six thousand seven hundred and sixty-eight articles were searched out.After screening,28 articles were included in the final analysis,involving six kinds of Chinese patent drugs for promoting blood circulation and removing blood stasis,i.e.,Jingtong(颈痛,JT)granule,Jingshu(颈舒,JS)granule,Jitongxiao(脊痛消,JTX)capsule,Biqi(痹祺,BQ)capsule,Shujin Tongluo(舒筋通络,SJTL)granule and Jingfukan(颈复康,JFK)granule.The results of reticulated Meta-analysis showed that,in adjuvant treatment of CSR,JT granule combined with conventional therapy(CT)(SUCRA=78.4%)behaved best in clinical effective rate,followed by BQ capsule combined with CT(SUCRA=71.6%),JS granule combined with CT(SUCRA=62.1%),SJTL granule combined with CT(SUCRA=53.7%),JTX capsule combined with CT(SUCRA=43.3%),JFK granule combined with CT(SUCRA=40.5%)and CT(SUCRA=0.4%); and SJTL granule combined with CT(SUCRA=96.3%)behaved best in neck pain VAS score,followed by BQ capsule combined with CT(SUCRA=86.2%),JFK granule combined with CT(SUCRA=51.6%),JT granule combined with CT(SUCRA=50.8%),JS granule combined with CT(SUCRA=37.4%),JTX capsule combined with CT(SUCRA=27.4%)and CT(SUCRA=0.4%); and BQ capsule combined with CT(SUCRA=95%)behaved best in NDI,followed by JFK granule combined with CT(SUCRA=71.3%),JT granule combined with CT(SUCRA=69.2%),JTX capsule combined with CT(SUCRA=38.7%),JS granule combined with CT(SUCRA=20.8%)and CT(SUCRA=5.0%).Conclusion:Available evidences suggest that,in adjuvant treatment of CSR,the JT granule behaves best in the total outcomes,the SJTL granule performs best in alleviating neck pain,and the BQ capsule acts best in improving neck vertebra function.However,due to the difference in non-surgical therapies used in the control group,as well as the limitations in the quantity and quality of the articles,the conclusion here need to be further verified.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(82060874)
通讯作者:任晓平 E-mail:chinarenxg@126.com
更新日期/Last Update: 1900-01-01