[1]杨焕莹,王想福,赵道洲,等.口服独活寄生汤治疗经皮内窥镜下腰椎间盘切除术后残余症状的Meta分析[J].中医正骨,2022,34(07):34-39.
　YANG Huanying,WANG Xiangfu,ZHAO Daozhou,et al.Oral application of Duhuo Jisheng Tang(独活寄生汤)for treatment of residual symptoms following percutaneous endoscopic lumbar discectomy:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(07):34-39.
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口服独活寄生汤治疗经皮内窥镜下腰椎间盘切除术后残余症状的Meta分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年07期
页码:
34-39
栏目:
文献研究
出版日期:
2022-07-20

文章信息/Info

Title:
Oral application of Duhuo Jisheng Tang(独活寄生汤)for treatment of residual symptoms following percutaneous endoscopic lumbar discectomy:a meta-analysis
作者:
杨焕莹1; 王想福2; 赵道洲2; 李晨旭2; 张万乾1; 陈伟国2; 桑廷瑞1; 张超1; 丁艳芳1; 张晶博1
(1.甘肃中医药大学,甘肃 兰州 730000; 2.甘肃省中医院,甘肃 兰州 730050)
Author(s):
YANG Huanying1; WANG Xiangfu2; ZHAO Daozhou2; LI Chenxu2; ZHANG Wanqian1; CHEN Weiguo2; SANG Tingrui1; ZHANG Chao1; DING Yanfang1; ZHANG Jingbo1
1.Gansu University of Chinese Medicine,Lanzhou 730000,Gansu,China 2.Gansu Provincial Hospital of TCM,Lanzhou 730050,Gansu,China
关键词:
椎间盘移位;  腰椎;  独活寄生汤;  椎间盘切除术; 经皮;  术后残余症状;  专题Meta分析
Keywords:
intervertebral disc displacement;  lumbar vertebrae;  Duhuo Jisheng decoction;  diskectomy; percutaneous;  postoperative residual symptoms;  meta-analysis as topic
摘要:
目的:评价口服独活寄生汤治疗经皮内窥镜下腰椎间盘切除术(percutaneous endoscopic lumbar discectomy,PELD)后残余症状的临床疗效。方法:应用计算机检索中国知网、维普网、万方数据库、中国生物医学文献服务系统、PubMed、Embase、Cochrane Library和Web of Science中关于口服独活寄生汤治疗PELD术后残余症状的随机对照试验文献,检索时限为建库至2021年7月1日。试验组采用口服独活寄生汤治疗,也可联合口服抗生素、口服甲钴胺或常规康复治疗; 对照组采用口服抗生素、口服甲钴胺或常规康复治疗。由2名研究者独立检索、筛选文献,提取资料,并采用Cochrane偏倚风险评估工具对纳入文献的质量及偏倚风险进行评估。采用RevMan5.3软件进行Meta分析。结果:共检索出49篇相关文献,通过逐层筛选,最终纳入8篇文献,均为中文文献,共涉及700例患者,其中试验组351例、对照组349例。Meta分析结果显示,试验组患者腰腿部疼痛视觉模拟量表评分、腰椎Oswestry功能障碍指数评分均低于对照组[MD=-0.77,95%CI(-0.94,-0.59),P =0.000; MD=-7.98,95%CI(-9.10,-6.86),P=0.000],试验组患者日本骨科协会腰痛疾患疗效评分、尼龙绳试验评分均高于对照组[MD=3.51,95%CI(2.74,4.28),P=0.000; MD=1.96,95%CI(1.64,2.28),P=0.000]。结论:现有的证据表明,口服独活寄生汤可以缓解PELD术后的腰腿部疼痛及下肢麻木、无力等症状,改善腰椎功能。
Abstract:
Objective:To evaluate the clinical outcomes of oral application of Duhuo Jisheng Tang(独活寄生汤,DHJST)for treatment of residual symptoms emerged after percutaneous endoscopic lumbar discectomy(PELD).Methods:All the randomized controlled trial(RCT)articles about oral application of DHJST for treatment of residual symptoms emerged after PELD included from database establishing to July 1,2021 were retrieved from the China National Knowledge Internet,Vip Database,Wanfang Database,Chinese Biomedical Literature Service System,PubMed,Embase,Cochrane Library and Web of Science through computer.The patients in experimental group were treated with oral application of DHJST,or combined with oral application of antibiotics,oral application of mecobalamine or conventional rehabilitation therapy; while the ones in control group with oral application of antibiotics,oral application of mecobalamine or conventional rehabilitation therapy alone.The articles were retrieved and screened and the information was extracted independently by two researchers according to the inclusion and exclusion criteria,and if any disagreement was found between them,discussion was conducted or asked for another researcher for making a final decision.The methodological quality and bias risk of research in the articles was evaluated by using Cochrane bias risk assessment tools,and then a Meta-analysis was conducted by using RevMan5.3 software.Results:Forty-nine articles were searched out.After screening,8 Chinese articles(700 patients)were included in the final analysis,351 patients in experimental group and 349 ones in control group.The results of Meta-analysis revealed that the lumbago-leg pain visual analogue scale(VAS)scores and lumbar Oswestry disability index(ODI)scores were lower,while the Japanese Orthopaedic Association(JOA)low back pain efficacy scores and Nylon rope test scores were higher in experimental group compared to control group(MD=-0.77,95%CI(-0.94,-0.59),P =0.000; MD=-7.98,95%CI(-9.10,-6.86),P=0.000; MD=3.51,95%CI(2.74,4.28),P=0.000; MD=1.96,95%CI(1.64,2.28),P=0.000).Conclusion:Available evidences suggest that oral application of DHJST can relieve the residual symptoms such as lumbar-leg pain,lower limbs numbness-weakness and improve the lumbar function in patients who undergo PELD.

参考文献/References:

[1] ROGERSON A,AIDLENJ,JENIS L G.Persistent radiculo-pathy after surgical treatment for lumbar disc herniation:causes and treatment options[J].Int Orthop,2019,43(4):969-973.
[2] MO Z,ZHANG R,CHEN J,et al.Comparison between oblique pulling spinal manipulation and other treatments for lumbar disc herniation:a systematic review and meta-analysis[J].J Manipulative Physiol Ther,2018,41(9):771-779.
[3] CHIU C C,CHUANG T Y,CHANG K H,et al.The probability of spontaneous regression of lumbar herniated disc:a systematic review[J].Clin Rehabil,2015,29(2):184-195.
[4] HE S,SUN Z,WANG Y,et al.Combining YESS and TESSYS techniques during percutaneous transforaminal endoscopic discectomy for multilevel lumbar disc herniation[J].Medicine(Baltimore),2018,97(28):e11240.
[5] TACCONI L,BALDO S,MERCI G,et al.Transforaminal percutaneous endoscopic lumbar discectomy:outcome and complications in 270 cases[J].J Neurosurg Sci,2020,64(6):531-536.
[6] YANG J S,LIU K X,CHU L,et al.Cocktail treatment with a gelatin sponge impregnated with ropivacaine,dexamethasone, and vitamin B12 promotes early postoperative recovery after percutaneous endoscopic lumbar discectomy:a retrospective,case-controlled study[J].Pain Physician,2020,23(2):E211-E218.
[7] 黄国珠,潘汉升,高海滨,等.中医药对腰椎间盘突出症患者椎间孔镜术后残余疼痛症状的研究进展[J].中国当代医药,2019,26(23):16-20.
[8] ZHANG X,TAN R,LAM W C,et al.PRISMA(preferred reporting items for systematic reviews and meta-analyses)extension for Chinese herbal medicines 2020(PRISMA-CHM 2020)[J].Am J Chin Med,2020,48(6):1279-1313.
[9] 张立源,宋鹏程,宋雪,等.自拟独活寄生汤治疗腰椎间盘突出症椎间孔镜术后的感觉异常[J].国际中医中药杂志,2018,40(12):1138-1141.
[10] 朱云峰.独活寄生汤联合侧路椎间孔镜下椎间盘髓核摘除术治疗腰椎间盘突出症患者的临床研究[J].实用医技杂志,2020,27(8):1075-1077.
[11] 林华杰,金甬,贾晋荣,等.独活寄生汤治疗腰椎间盘突出症椎间孔镜术后临床研究[J].新中医,2020,52(5):50-52.
[12] 王爱慧.独活寄生汤加减治疗腰椎间盘突出症椎间孔镜术后感觉不适的疗效[J].黑龙江医药,2019,32(2):373-375.
[13] 蒋啸.独活寄生汤加减治疗LDH椎间孔镜术后残留症状的疗效观察[D].昆明:云南中医学院,2018.
[14] 贾琼,柴旭斌,钟炜钰.口服独活寄生汤治疗腰椎间盘突出症椎间孔镜术后感觉异常[J].中医正骨,2016,28(2):11-14.
[15] 邓小磊,侯德才.独活寄生汤加减治疗腰椎间盘突出症患者椎间孔镜髓核摘除术后残余痛的临床研究[J].河北中医,2019,41(8):1213-1217.
[16] 韦金忠,凌义龙,沈兴潮.独活寄生汤加减对椎间盘突出症脊柱内镜术后残留腰痛的影响[J].中华全科医学,2020,18(11):1929-1932.
[17] ZHAO Y,FAN Y,YANG L,et al.Percutaneous endoscopic lumbar discectomy(PELD)via a transforaminal and interlaminar combined approach for very highly migrated lumbar disc herniation(LDH)between L4/5 and L5/S1 level[J].Med Sci Monit,2020,26:e922777.
[18] ZOU H J,HU Y,LIU J B,et al.Percutaneous endoscopic transforaminal lumbar discectomy via eccentric trepan foraminoplasty technology for unilateral stenosed serve root canals[J].Orthop Surg,2020,12(4):1205-1211.
[19] HUANG Y,YIN J,SUN Z,et al.Percutaneous endoscopic lumbar discectomy for LDH via a transforaminal approach versus an interlaminar approach:a meta-analysis[J].Orthopade,2020,49(4):338-349.
[20] WU J,FANG Y,JIN W.Seizures after percutaneous endoscopic lumbar discectomy:a case report[J].Medicine(Baltimore),2020,99(47):e22470.
[21] 赵杉,贺石生,张海龙.椎间孔镜术后感觉异常的危险因素及处理[J].实用骨科杂志,2014,20(11):1051-1052.
[22] AHN Y,LEE H Y,LEE S H,et al.Dural tears in percutanerousen-doscopic lumbar discectomy[J].Eur Spine J,2011,20(1):58-64.
[23] 尹利强,张建,牛宇飞,等.改良靶向经皮椎间孔入路脊柱内镜下髓核摘除术治疗腰椎间盘突出症的效果观察[J].中国实用医刊,2020,47(18):59-61.
[24] 张西峰,王岩,刘郑生,等.神经妥乐平治疗腰椎间盘突出术后残余神经症状的临床观察[J].中国疼痛医学杂志,2006,12(1):21-23.
[25] COSAMALN-GAN I,COSAMALN-GAN T,MATTOS-PIAGGIO G,et al.Inflammation in the intervertebral disc herniation[J].Neurocirugia(Astur:Engl Ed),2021,32(1):21-35.
[26] 孙鹏飞,周铖,刘锌,等.从“骨错缝、筋出槽”理论探析腰椎间盘突出症椎间孔镜术后残余症状影响因素[J].辽宁中医杂志,2021,48(12):89-92.
[27] 白子兴,董永丽,蔡静怡,等.独活寄生汤干预腰椎间盘突出症的可视化“药靶蛋白模型”分析[J].世界中医药,2021,16(18):2657-2662.
[28] 周桦,卢建华.独活寄生汤对椎间盘内紊乱兔模型髓核组织中IL-1β及PGE_2的影响[J].中华中医药杂志,2016,31(2):665-667.
[29] LIU Z C,WANG Z L,HUANG C Y,et al.Duhuo Jisheng decoction inhibits SDF-1-induced inflammation and matrix degradation in human degenerative nucleus pulposus cells in vitro through the CXCR4/NF-κB pathway[J].Acta Pharmacol Sin,2018,39(6):912-922.
[30] WU G,FAN H,HUANG Y,et al.Duhuo Jisheng decoction-containing serum promotes proliferation of interleukin-1β-induced chondrocytes through the p16-cyclin D1/CDK4-Rb pathway[J].Mol Med Rep,2014,10(5):2525-2534.

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备注/Memo

备注/Memo:
基金项目:甘肃省科技计划项目(21JR1RA058); 兰州市人才创新创业项目(2020-RC-54) 通讯作者:王想福 E-mail:wangxf_1969@163.com
更新日期/Last Update: 1900-01-01