口服中成药治疗腰椎间盘突出症有效性和安全性的网状Meta分析

目的]采用网状Meta分析方法评价不同口服中成药对腰椎间盘突出症（LDH）的有效性和安全性，为临床用药提供了循证依据。方法]计算机检索中国知网（CNKI）、万方（WanFang）、维普（VIP）、中国生物医学文献数据库（CBM）、PubMed、Embase、Cochrane Library数据库，自建库至2022年2月收录的口服中成药治疗LDH的随机对照试验（RCTs），通过Cochrane推荐的分析与偏倚风险评估工具对所纳入的RCTs进行质量评估，用RevMan5.4和Stata15.1对口服中成药治疗LDH的有效性和安全性进行分析评价。结果]纳入24项RCTs，共包括6种中成药。网状Meta分析结果表明，在临床有效性方面，排名前三的中成药为痹祺胶囊、舒筋健腰丸、腰痹通胶囊；在改善VAS评分方面，排名前三的中成药为腰腿痛宁胶囊、舒筋健腰丸、腰痛宁胶囊；在药物安全性方面，各项研究均未出现严重不良反应事件，多数研究仅报道了中成药的轻度胃肠道反应。结论]综合比较口服中成药可提高腰椎间盘突出症的临床疗效，安全性好；但受纳入文献的质量和数量所限，该结论仍需要更多高质量研究予以进一步验证...

Efficacy and safety of oral Chinese patent medicine in the treatment of lumbar disc herniation:a network Meta-analysis

Objective] To evaluate the efficacy and safety of different oral Chinese patent medicines on lumbar disc herniation (LDH) by means of network Meta-analysis and to provide evidence-based reference for clinical medication.Methods] CNKI,Wanfang,VIP,China Biomedical Database,PubMed,Embase,Cochrane Library database were searched for clinical randomized controlled trials of oral Chinese patent medicines in the treatment of LDH from the establishment of the database to February 2022. The quality of the included RCTs was evaluated using the risk of bias assessment tool recommended by Cochrane,and RevMan5.4 and Stata15.1 were used to evaluate the efficacy and safety of oral Chinese patent medicine in the treatment of LDH.Results] The 24 RCTs were included,involving a total of 6 proprietary Chinese medicines. The results of network Meta-analysis showed that the top three interventions in improving clinical efficacy were Biqi Capsules,Shujin Jianyao Pills and Yaobitong Capsules. In reducing VAS score,the top three interventions were Yaotui Tongning Capsules,Shujin Jianyao Pills and Yaotongning Capsules. In terms of drug safety,there were no serious adverse events in all studies,and most studies only reported mild gastrointestinal reactions of Chinese patent medicines.Conclusion] Comprehensive comparison oral Chinese patent medicine can improve the clinical efficacy of lumbar disc herniation and has good safety,but limited by the quality and quantity of the included literature,the conclusion still needs more high-quality research to verify.