| 引用本文:时福东，张世民，陈春，靳蛟，林海，莫靖煊.针灸推拿等中医特色非药物疗法治疗腰椎间盘突出症的网状Meta分析[J].世界中医药,2023,(23):. |
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| 针灸推拿等中医特色非药物疗法治疗腰椎间盘突出症的网状Meta分析 |
| Network Meta-analysis of Non-drug Therapy of Traditional Chinese Medicine such as Acupuncture and Massage in Treatment of Lumbar Disc Herniation |
| 投稿时间：2022-05-07 |
| DOI：10.3969/j.issn.1673-7202.2023.23.009 |
| 中文关键词: 腰椎 椎间盘 非药物治疗 针灸 推拿 牵引 网状Meta |
| English Keywords:Lumbar spine Intervertebral disc Non-drug therapy Acupuncture Massage Traction Network Meta-analysis |
| 基金项目:北京市中医药科技发展资金项目（JJ-2020-75） |
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| 中文摘要: |
| 目的：系统评价针刺、推拿等非药物疗法治疗腰椎间盘突出症的临床疗效。方法：检索国家知识基础设施数据库（CNKI）、中国学术期刊数据库（CSPD）、中国生物医学文献数据库（CBM）和PubMed、Cochrane Library文献数据库，利用贝叶斯网状Meta分析方法，纳入针刺、推拿、牵引以及灸法单一或联合使用治疗腰椎间盘突出症的随机对照试验，根据Cochrane协作网推荐的偏倚风险工具对纳入文献进行质量评价，使用RevMan 5.3软件制作成偏倚风险图，Ge MTC.0.14.3软件对数据进行网状Meta分析，通过Stata 16.0软件制作网状图、累计排序图、预测区间图以及比较-校正漏斗图。结果：共纳入28篇随机对照试验研究，2 771例患者，共有10种干预措施，网状Meta分析结果显示：总有效率：针刺+推拿，推拿+牵引，针刺+灸法，针刺+牵引，推拿+灸法，针刺+推拿+牵引结果优于单独牵引；针刺+推拿，针刺+灸法优于单独灸法或单独针刺；针刺+推拿，针刺+灸法以及推拿+牵引有效率优于单独推拿。视觉模拟评分（VAS）：针刺+灸法优于单纯推拿，针刺+灸法，针刺+推拿+牵引优于单纯牵引。结论：在总有效率方面，针刺+推拿疗效最佳；在缓解疼痛方面，针刺+牵引可能是最优的选择，不同干预措施可能存在叠加效应且叠加效果有限。 |
| English Summary: |
| This paper aims to systematically evaluate the clinical efficacy of acupuncture，massage，and other non-drug therapies in the treatment of lumbar disc herniation.Methods:The databases of CNKI，CSPD，CBM，PubMed，and Cochrane Library were searched.Bayesian mesh meta-analysis was used，and a randomized controlled trial for the treatment of lumbar disc herniation was conducted，with acupuncture，massage，traction，and moxibustion used respectively or jointly.The quality of the included literature was evaluated according to the bias risk tool recommended by Cochrane.The bias risk map was prepared using RevMan 5.3 software，and the network meta-analysis of the data was performed by Ge MTC.0.14.3.Stata 16.0 software was used to make a network diagram，cumulative sorting diagram，prediction interval diagram，and comparative-correction funnel diagram.Results:A total of 28 randomized controlled trials were included，with 2 771 subjects and 10 interventions.The network meta-analysis results showed that the total effective rate of acupuncture+massage，massage+traction，acupuncture+moxibustion，acupuncture+traction，massage+moxibustion，and acupuncture+massage+traction was better than that of traction alone.Acupuncture+massage and acupuncture+moxibustion were better than moxibustion or acupuncture alone.The effective rate of acupuncture+massage，acupuncture+moxibustion，and massage+traction was better than that of massage alone.The visual analogue scale (VAS) of acupuncture+moxibustion was better than that of simple massage，while acupuncture+moxibustion and acupuncture+massage+traction were better than simple traction.Conclusion:Acupuncture+massage has the best effect in terms of total effective rate.In terms of pain relief，acupuncture+traction may be the optimal choice，and different interventions may have limited additive effects. |
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