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[1]吳卓檀,任曉平,蘭榮玉,等.活血化瘀類中成藥輔助治療神經根型頸椎病有效性的網狀Meta分析[J].中醫(yī)正骨,2024,36(01):33-42.
　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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活血化瘀類中成藥輔助治療神經根型頸椎病有效性的網狀Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期數(shù):
2024年01期
頁碼:
33-42
欄目:
文獻研究
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:
吳卓檀1; 任曉平2; 蘭榮玉2; 張衛(wèi)華2; 申婷婷1; 韓林軒2; 吳曉飛2; 楊漢立1
1.廣西中醫(yī)藥大學研究生院,廣西 南寧 530001; 2.廣西中醫(yī)藥大學附屬瑞康醫(yī)院,廣西 南寧 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
關鍵詞:
頸椎病;  神經根病;  活血祛瘀;  中成藥;  網絡Meta分析
Keywords:
cervical spondylosis;  radiculopathy;  promoting blood circulation for removing blood stasis;  Chinese patent drugs;  network meta-analysis
摘要:
目的:系統(tǒng)評價不同活血化瘀類中成藥輔助治療神經根型頸椎病(cervical spondylotic radiculopathy,CSR)的臨床療效。方法:應用計算機檢索中國知網、維普網、萬方數(shù)據(jù)庫、PubMed、Web of Science和Cochrane Library中關于活血化瘀類中成藥輔助治療CSR的隨機對照試驗,檢索時限均為建庫至2023年9月20日。對照組單純采用常規(guī)非手術方法治療,試驗組在對照組的基礎上聯(lián)合活血化瘀類中成藥口服治療。依據(jù)文獻檢索及篩選方案篩選出符合要求的文獻后,由2名研究人員分別獨立進行數(shù)據(jù)提取和質量評價。采用Stata18.0軟件繪制網狀關系圖,對治療有效率、頸部疼痛視覺模擬量表(visual analogue scale,VAS)評分、頸椎功能障礙指數(shù)(neck disability index,NDI)進行網狀Meta分析,并根據(jù)累計概率排名曲線下面積(the surface under the cumulative ranking curve,SUCRA)對治療方法的療效進行排序。采用比較-校正漏斗圖進行發(fā)表偏倚檢驗。結果:共檢索到6768篇文獻,通過逐層篩選最終納入28篇文獻,涉及頸痛顆粒、頸舒顆粒、脊痛消膠囊、痹祺膠囊、舒筋通絡顆粒、頸復康顆粒共6種活血化瘀類中成藥。網狀Meta分析結果顯示,在治療有效率方面,不同活血化瘀類中成藥輔助治療CSR的療效排序為頸痛顆粒聯(lián)合常規(guī)治療(SUCRA=78.4%)>痹祺膠囊聯(lián)合常規(guī)治療(SUCRA=71.6%)>頸舒顆粒聯(lián)合常規(guī)治療(SUCRA=62.1%)>舒筋通絡顆粒聯(lián)合常規(guī)治療(SUCRA=53.7%)>脊痛消膠囊聯(lián)合常規(guī)治療(SUCRA=43.3%)>頸復康顆粒聯(lián)合常規(guī)治療(SUCRA=40.5%)>常規(guī)治療(SUCRA=0.4%); 在頸部疼痛VAS評分方面,不同活血化瘀類中成藥輔助治療CSR的療效排序為舒筋通絡顆粒聯(lián)合常規(guī)治療(SUCRA=96.3%)>痹祺膠囊聯(lián)合常規(guī)治療(SUCRA=86.2%)>頸復康顆粒聯(lián)合常規(guī)治療(SUCRA=51.6%)>頸痛顆粒聯(lián)合常規(guī)治療(SUCRA=50.8%)>頸舒顆粒聯(lián)合常規(guī)治療(SUCRA=37.4%)>脊痛消膠囊聯(lián)合常規(guī)治療(SUCRA=27.4%)>常規(guī)治療(SUCRA=0.4%); 在NDI方面,不同活血化瘀類中成藥輔助治療CSR的療效排序為痹祺膠囊聯(lián)合常規(guī)治療(SUCRA=95%)>頸復康顆粒聯(lián)合常規(guī)治療(SUCRA=71.3%)>頸痛顆粒聯(lián)合常規(guī)治療(SUCRA=69.2%)>脊痛消膠囊聯(lián)合常規(guī)治療(SUCRA=38.7%)>頸舒顆粒聯(lián)合常規(guī)治療(SUCRA=20.8%)>常規(guī)治療(SUCRA=5.0%)。結論:現(xiàn)有的證據(jù)表明,頸痛顆粒輔助治療CSR的綜合療效最佳,舒筋通絡顆粒在緩解頸部疼痛方面效果最佳,痹祺顆粒在改善頸椎功能方面效果最佳。但由于對照組采用的非手術療法不盡相同及文獻數(shù)量、質量等的限制,本研究的結論尚需進一步驗證。
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(頸痛,JT)granule,Jingshu(頸舒,JS)granule,Jitongxiao(脊痛消,JTX)capsule,Biqi(痹祺,BQ)capsule,Shujin Tongluo(舒筋通絡,SJTL)granule and Jingfukan(頸復康,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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備注/Memo

備注/Memo:
基金項目:國家自然科學基金項目(82060874)
通訊作者:任曉平 E-mail:[email protected]
更新日期/Last Update: 1900-01-01