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[1]張人文,莫灼錨,常敏敏,等.坐位定點旋轉(zhuǎn)手法與斜扳手法治療腰椎間盤突出癥的系統(tǒng)評價[J].中醫(yī)正骨,2018,30(12):30-36.
　ZHANG Renwen,MO Zhuomao,CHANG Minmin,et al.Fixed-point rotation manipulation in sitting position versus oblique-pulling manipulation for treatment of lumbar intervertebral disc herniation:a systematic review[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(12):30-36.
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坐位定點旋轉(zhuǎn)手法與斜扳手法治療腰椎間盤突出癥的系統(tǒng)評價()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年12期
頁碼:
30-36
欄目:
文獻研究
出版日期:
2018-12-20

文章信息/Info

Title:
Fixed-point rotation manipulation in sitting position versus oblique-pulling manipulation for treatment of lumbar intervertebral disc herniation:a systematic review
作者:
張人文; 莫灼錨; 常敏敏; 楊彬彬; 李冬; 陳金鳳; 舒新農(nóng); 唐樹杰
(暨南大學(xué),廣東 廣州 510632)
Author(s):
ZHANG Renwen; MO Zhuomao; CHANG Minmin; YANG Binbin; LI Dong; CHEN Jinfeng; SHU Xinnong; TANG Shujie
Jinan University,Guangzhou 510632,Guangdong,China
關(guān)鍵詞:
椎間盤移位;  腰椎;  推拿; 脊柱;  Meta分析
Keywords:
intervertebral disc displacement;  lumbar vertebrae;  manipulation; spinal;  meta-analysis
摘要:
目的:比較坐位定點旋轉(zhuǎn)手法與斜扳手法治療腰椎間盤突出癥(lumbar intervertebral disc herniation,LIDH)的臨床療效和安全性。方法:應(yīng)用計算機檢索Cochrane Library、PubMed、Embase、Web of science、CNKI、WanFang Data、VIP建庫至2018年4月收錄的國內(nèi)外公開發(fā)表的、比較坐位旋轉(zhuǎn)手法與斜扳手法治療LIDH臨床療效的隨機對照研究文獻或觀察性研究文獻。由2位研究者獨立篩選文獻、提取資料。對納入文獻質(zhì)量進行評價后,進行Meta分析。結(jié)果:初檢共檢出文獻2164篇,經(jīng)篩選最終納入9篇文獻,均為中文文獻。納入文獻中7篇為隨機對照研究,2篇為觀察性研究文獻; 納入的研究對象共825例,坐位旋轉(zhuǎn)手法組422例、斜扳手法組403例; 結(jié)局指標(biāo)包括有效率、日本整形外科協(xié)會(Japanese orthopedic association,JOA)下腰痛評分、疼痛視覺模擬量表(visual analogue scale,VAS)評分、Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)、SF-36簡明健康狀況調(diào)查表中軀體疼痛(body pain,BP)評分和生理功能(physical function,PF)評分、血清白細(xì)胞介素-6(interleukin-6,IL-6)含量。Meta分析結(jié)果顯示,坐位旋轉(zhuǎn)手法治療LIDH的有效率及JOA評分和BP評分均高于斜扳手法[RR=1.09,95%CI(1.04,1.15); MD=4.34,95%CI(3.01,5.67); MD=3.12,95%CI(0.93,5.30)],VAS評分低于斜扳手法[MD=-1.51,95%CI(-2.02,-1.01)]; 但治療后兩種方法ODI和PF評分的組間比較及末次隨訪時ODI的組間比較,差異均無統(tǒng)計學(xué)意義[MD=-2.31,95%CI(-10.87,6.24); MD=0.05,95%CI(-4.39,4.49); MD=-3.59,95%CI(-10.10,2.29)]。僅1篇文獻比較了坐位定點旋轉(zhuǎn)手法和斜扳手法治療LIDH后的血清IL-6含量,未進行Meta分析。5篇文獻報告坐位定點旋轉(zhuǎn)手法和斜扳手法治療LIDH均未出現(xiàn)明顯不良反應(yīng),其他4篇文獻未提及不良反應(yīng)。結(jié)論:與斜扳手法相比,坐位定點旋轉(zhuǎn)手法治療LIDH有效率更高,在緩解疼痛方面更有優(yōu)勢,但兩種方法在改善腰椎功能和患者日常生活能力方面的作用相當(dāng)。
Abstract:
Objective:To compare the curative effects and safety of fixed-point rotation manipulation in sitting position versus oblique-pulling manipulation for treatment of lumbar intervertebral disc herniation(LIDH).Methods:All the randomized controlled trial(RCT)articles and observational research articles about the curative effects of fixed-point rotation manipulation in sitting position(group A)versus oblique-pulling manipulation(group B)for treatment of LIDH that published at home and abroad included from database establishing to April 2018 were retrieved from Cochrane Library,Pubmed,Embase,Web of science,China national knowledge internet,WanFang Database and VIP Database through computer.The articles were screened and the information was extracted independently by two searchers.The quality of articles was evaluated and a Meta-analysis was conducted.Results:Two thousand one hundred and sixty-four articles were searched out in the initial stage.After screening,9 Chinese articles(825 patients)were included in the final analysis,including 7 RCT articles and 2 observational research articles,and 422 patients in group A and 403 patients in group B.The outcome indicators included effective rate,Japanese orthopedic association(JOA)low back pain scores,pain visual analogue scale(VAS)scores,Oswestry disability index(ODI),body pain(BP)scores and physical function(PF)scores in SF-36 and serum contents of interleukin-6(IL-6).The results of Meta-analysis demonstrated that the effective rate,JOA scores and BP scores were higher and the VAS scores were lower in group A compared to group B in treatment of LIDH(RR=1.09,95%CI(1.04,1.15); MD=4.34,95%CI(3.01,5.67); MD=3.12,95%CI 5.30); MD=-1.51,95%CI(-2.02,-1.01)).There was no statistical difference in posttreatment ODI and PF scores and ODI at last follow-up between the 2 groups(MD=-2.31,95%CI(-10.87,6.24); MD=0.05,95%CI(-4.39,4.49); MD=-3.59,95%CI(-10.10,2.29)).The posttreatment serum contents of IL-6 were compared between group A and group B in one article,so no Meta-analysis was conducted.Five articles reported that no obvious adverse reactions were found during the treatment of LIDH by using fixed-point rotation manipulation in sitting position and oblique-pulling manipulation,and adverse reactions were unmentioned in the other four articles.Conclusion:Fixed-point rotation manipulation in sitting position surpasses oblique-pulling manipulation in effective rate and pain relief in treatment of LIDH,however,the two methods are similar to each other in improving lumbar function and activity of daily living.

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備注/Memo

備注/Memo:
基金項目:廣東省自然科學(xué)基金項目(2016A030313076); 廣州市科技計劃項目(201607010252) 通訊作者:唐樹杰 E-mail:tsj697@163.com(收稿日期:2018-06-15 本文編輯:楊雅)
更新日期/Last Update: 2019-05-30