靶点射频热凝联合臭氧治疗腰椎间盘突出症的Meta分析

背景：靶点射频热凝联合臭氧为治疗腰椎间盘突出症提出了新思路，两者联合介入微创治疗能发挥各自优势，但其疗效尚缺乏循证医学证据支持。目的：评价射频热凝靶点消融联合臭氧治疗腰椎间盘突出症的有效性和可行性。方法：计算机检索PubMed、CENTRAL、SCI、EMBASE.com、中国生物医学文献数据库、万方数据库、中国期刊全文数据库等，检索时限均从建库开始至2013年6月22日。严格根据纳入排除标准，收集射频热凝术联合臭氧治疗腰椎间盘突出症的随机对照试验，依据Cochrane Handbook 5.1.0偏倚风险评估工具评价纳入研究质量，采用RevMan 5.2软件进行Meta分析。结果与结论：数据库检索获得63条记录，最终纳入8个随机对照试验，662例患者。Meta分析结果显示：与单独臭氧组比较，射频热凝联合臭氧治疗后1周、3个月、6个月的优良率[RR=0.36，95%CI(0.21，0.59)；RR=0.24，95%CI(0.14，0.43)；RR=0.41，95%CI(0.24，0.70)]、有效率[RR=0.31，95%CI(0.12，0.82)；RR=0.28, 95%CI(0.09，0.84)；RR=0.22，95%CI(0.06，0.80)]、目测类比评分[MD=-1.06，95%CI(-1.83，-0.28)]差异有显著性意义。结果可见，应用射频热凝联合臭氧注射治疗后腰椎间盘突出症患者疼痛缓解程度高，见效快，远期疗效好，安全可行。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程全文链接：

Radiofrequency ablation combined with ozone in the treatment of lumbar disc herniation: a meta-analysis

BACKGROUND: Support radiofrequency ablation combined with ozone provides novel idea for lumbar disc herniation. Their combination intervened with minimally invasive surgery can bring their advantages, but its therapeutic effect still lacks of evidences from evidence-based medicine. OBJECTIVE: To evaluate the effectiveness and feasibility of radiofrequency ablation combined with ozone for lumbar disc herniation. METHODS: Systematic and comprehensive database search was performed in PubMed, CENTRAL, SCI, EMBASE.com, Chinese Biomedical Literature Database, China National Knowledge Infrastructure and Wanfang database for literatures published from database establishment to June 22 2013. According to inclusion and exclusion criteria, randomized controlled trials on support radiofrequency ablation combined with ozone for lumbar disc herniation were collected. The risk of bias tool described in the Cochrane Handbook version 5.1.0 was used to assess the quality of each trial. Meta-analysis was performed using RevMan 5.2 software. RESULTS AND CONCLUSION:Totally 63 records were collected. A total of 8 randomized controlled trials  involving 662 patients met inclusion criteria. The results of meta-analysis showed between ozone alone, and at 1 week, 3 and 6 months after combined treatment, significant differences were detected in excellent and good rate [RR=0.36, 95%CI(0.21, 0.59); RR=0.24, 95%CI(0.14, 0.43); RR=0.41, 95%CI(0.24, 0.70)], effective rate [RR=0.31, 95%CI(0.12, 0.82); RR=0.28, 95%CI(0.09, 0.84); RR=0.22, 95%CI(0.06, 0.80)], and visual analogue scale score [MD=-1.06, 95%CI(-1.83, -0.28)]. Results indicated that radiofrequency ablation combined with ozone is effective and feasible for lumbar disc herniation, with the characteristics of fast recovery, pain relief, and good long-period therapeutic effects.