腰椎间盘突出症手术与非手术治疗疗效的荟萃分析

目的用循证医学荟萃分析方法对早期手术与非手术治疗腰椎间盘突出症的文献进行疗效及安全性系统评价,探索其治疗方法的规范化和标准化。方法本论文对Medline和中国期刊全文数据库进行了电子检索。所检索到的文献中早期手术与非手术治疗腰椎间盘突出症的随机对照试验和半随机对照试验都被纳入。采用Jadad质量计分法对文献进行质量评价。用Meta分析对两组的恢复率进行评价。结果共检索到659篇文献,最后共纳入4篇早期手术与非手术治疗腰椎间盘突出症坐骨神经痛随机对照试验,对其中3篇Meta分析结果显示手术组恢复率明显较对照组高（RR=4.82,95%可信限为2.94~7.90,P〈0.000 01）,异质性检验有统计学意义（P=0.000 3）。结论从现有的文献临床证据来看,手术治疗的短期效果明显,但由于所获得的文献试验质量不高,以及研究方法的缺陷,现有的证据还不足以得出肯定的结论。因此,需要更多大样本多中心的设计良好的随机对照试验来验证结果。

The Mate Analysis for Efficacy Evaluation about the Surgical and Non-Surgical Treatment of Sciatica

Objective Efficacy evaluation about the early surgical and non-surgical treatment of sciatica via meta-analysis.Methods Retrieval of database:Medline & CNKI.Quasi-randomized controlled trials and randomized controlled trials with respect to surgery and non-surgical treatment of sciatica were included.Using Jadad quality of a method to evaluate thequality of literature.Using meta-analysis on the recovery rate of the two groups.Results Totally four pieces of literatures including 567 cases were enrolled.All t...