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Report of the National Institutes of Health task force on research standards for chronic low back pain.美国国立卫生研究院慢性腰痛研究标准特别工作组报告。
J Manipulative Physiol Ther. 2014 Sep;37(7):449-67. doi: 10.1016/j.jmpt.2014.07.006. Epub 2014 Aug 12.
2
The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews.手法治疗与运动疗法对不同阶段非特异性下腰痛的疗效：系统评价的更新
J Man Manip Ther. 2014 May;22(2):59-74. doi: 10.1179/2042618613Y.0000000041.
3
Spinal manipulative therapy-specific changes in pain sensitivity in individuals with low back pain (NCT01168999).腰痛患者脊柱手法治疗特异性疼痛敏感性变化（NCT01168999）。
J Pain. 2014 Feb;15(2):136-48. doi: 10.1016/j.jpain.2013.10.005. Epub 2013 Oct 27.
4
Serious Adverse Events and Spinal Manipulative Therapy of the Low Back Region: A Systematic Review of Cases.严重不良事件与下腰部区域的脊柱推拿治疗：病例系统评价
J Manipulative Physiol Ther. 2015 Nov-Dec;38(9):677-691. doi: 10.1016/j.jmpt.2013.05.009. Epub 2013 Jun 17.
5
Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial.整脊手法治疗和超声治疗慢性下腰痛的随机对照试验。
Ann Fam Med. 2013 Mar-Apr;11(2):122-9. doi: 10.1370/afm.1468.
6
Spinal high-velocity low amplitude manipulation in acute nonspecific low back pain: a double-blinded randomized controlled trial in comparison with diclofenac and placebo.急性非特异性下腰痛的脊柱高速度低幅度手法治疗：与双氯芬酸和安慰剂比较的双盲随机对照试验。
Spine (Phila Pa 1976). 2013 Apr 1;38(7):540-8. doi: 10.1097/BRS.0b013e318275d09c.
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Spinal manipulative therapy for acute low-back pain.用于急性下背痛的脊柱推拿疗法。
Cochrane Database Syst Rev. 2012 Sep 12;2012(9):CD008880. doi: 10.1002/14651858.CD008880.pub2.
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Spinal manipulative therapy for chronic low-back pain.慢性下腰痛的脊柱推拿疗法。
Cochrane Database Syst Rev. 2011 Feb 16;2011(2):CD008112. doi: 10.1002/14651858.CD008112.pub2.
9
Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome?维持性脊柱推拿疗法治疗慢性非特异性下腰痛是否会产生更好的长期疗效？
Spine (Phila Pa 1976). 2011 Aug 15;36(18):1427-37. doi: 10.1097/BRS.0b013e3181f5dfe0.
10
Immediate effects of lumbar spine manipulation on the resting and contraction thickness of transversus abdominis in asymptomatic individuals.腰椎手法对无症状个体静息和收缩状态腹横肌厚度的即刻影响。
J Orthop Sports Phys Ther. 2011 Jan;41(1):13-21. doi: 10.2519/jospt.2011.3311. Epub 2010 Oct 22.

脊柱推拿与假推拿治疗非特异性下腰痛的系统评价与Meta分析

Spinal Manipulation Vs Sham Manipulation for Nonspecific Low Back Pain: A Systematic Review and Meta-analysis.

作者信息

Ruddock Jay K, Sallis Hannah, Ness Andy, Perry Rachel E

机构信息

Private Practice, Align Body Clinic, Bath, UK.

MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK; Centre for Academic Mental Health, School of Social and Community Medicine University of Bristol, Bristol, Bristol, UK.

出版信息

J Chiropr Med. 2016 Sep;15(3):165-83. doi: 10.1016/j.jcm.2016.04.014. Epub 2016 May 25.

DOI:10.1016/j.jcm.2016.04.014
PMID:27660593
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5021904/
Abstract

OBJECTIVE

The purpose of this systematic review was to identify and critically evaluate randomized controlled trials of spinal manipulation (SM) vs sham manipulation in the treatment of nonspecific low back pain.

METHODS

Four electronic databases were searched from their inception to March 2015 to identify all relevant trials. Reference lists of retrieved articles were hand-searched. All data were extracted by 2 independent reviewers, and risk of bias was assessed using the Cochrane Back Review Group Risk of Bias tool.

RESULTS

Nine randomized controlled trials were included in the systematic review, and 4 were found to be eligible for inclusion in a meta-analysis. Participants in the SM group had improved symptoms compared with participants receiving sham treatment (standardized mean difference = - 0.36; 95% confidence interval, - 0.59 to - 0.12). The majority of studies were of low risk of bias; however, several of the studies were small, the practitioner could not be blinded, and some studies did not conduct intention-to-treat analysis and had a high level of dropouts.

CONCLUSION

There is some evidence that SM has specific treatment effects and is more effective at reducing nonspecific low back pain when compared with an effective sham intervention. However, given the small number of studies included in this analysis, we should be cautious of making strong inferences based on these results.

摘要

目的

本系统评价的目的是识别并严格评估脊柱推拿（SM）与假推拿治疗非特异性下腰痛的随机对照试验。

方法

检索了四个电子数据库自创建至2015年3月的所有相关试验。对检索到的文章的参考文献列表进行了手工检索。所有数据由两名独立的审阅者提取，并使用Cochrane背部回顾小组偏倚风险工具评估偏倚风险。

结果

该系统评价纳入了9项随机对照试验，其中4项被认为符合纳入荟萃分析的条件。与接受假治疗的参与者相比，SM组参与者的症状有所改善（标准化均数差=-0.36；95%置信区间，-0.59至-0.12）。大多数研究的偏倚风险较低；然而，其中几项研究规模较小，从业者无法设盲，一些研究未进行意向性分析且失访率较高。

结论

有证据表明，与有效的假干预相比，SM具有特定的治疗效果，在减轻非特异性下腰痛方面更有效。然而，鉴于本分析纳入的研究数量较少，我们应谨慎基于这些结果做出强有力的推断。