手法治疗神经根型颈椎病临床随机对照试验的系统评价

目的评价手法治疗神经根型颈椎病的安全性以及有效性,分析目前治疗现状。方法检索PubMed全文数据库、OVID医学全文期刊数据库、Cochrane图书馆、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库以及手工检索,共收集手法治疗神经根型颈椎病的文献270篇,中文文献有254篇,英文文献16篇,其中9篇符合研究纳入标准,全部为中文文献;Cochrane系统评价手册进行质量评价;并对9篇文献采用RevMan4.2进行meta分析。结果纳入的9篇文献共1015例患者。9篇文献的治愈率汇总合并比值比(OR)为2.46,95%可信区间(CI)为(1.86,3.27);有效率汇总合并OR为2.85,95%CI为(1.87,4.35);手法组对神经根型颈椎病的治愈率、有效率均明显优于其他疗法(除手法之外的治疗方法,如针灸、药物等)组(P<0.01)。结论手法治疗神经根型颈椎病安全、有效,手法对神经根型颈椎病的治愈率、有效率明显优于其他疗法;但由于纳入文献的数量有限且质量不是很高,结论尚不确定,因此需要多中心的临床随机对照并且随访时间长的试验,来进一步验证。

Manipulation treatment on nerve-root-type cervical spondylosis systematic review of clinical randomized controlled trials

Objective To evaluate the safety and efficacy of the manipulation treatment on nerve-root-type cervical spondylosis and analyze the current status of clinical study. Methods By retrieving the PubMed, OVID, Cochrane Library, CBM-disc database, CNKI database, VIP Database, we collected 270 Literature of the manipulation treatment of nerve-root-type cervical spondylosis among which 9 studies met the inclusion criteria. Coehrane systematic review was used to quality evaluation and the 9 studies were analyzed by RevMan 4. 2 for Meta Analysis of Literature. Results The 9 documents included a total of 1015 patients. Summary of the literature combined OR for the cure rate is 2.46. 95% CI is （ 1.86, 3. 27）. Summary OR for the combined efficiency is 2. 85. 95% CI is （ 1.87, 4. 35 ）. Manipulation group＇ s cure rate of nerve-root-type cervical spondylosis is efficient and clearly superior to other therapies, such as medication, traction and acupuncture, hereinafter referred to as ＂other therapies＂ （ P〈0. 01 ）. Conclusions At present, documents included in this study have shown that manipulation treatment on nerve-root-type cervical spondylosis is safe, effective and both cure rate and the effective rate are much better than other therapies; but due to the limited number of documents included and the quality is not very high, the conclusion is still uncertain, high-quality evidence needed to be further validated.