Huang Chao-Yuan, Lu Yang, Sun Shu-Ning, Zhuang Li-Xing, Chen Xin-Lin
The 1stClinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
The 1stAffiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405.
Zhen Ci Yan Jiu. 2016 Jun 25;41(3):255-64.
To systematically review the effectiveness and safety of heat-sensitive moxibustion (HSM) therapy in the treatment of lumbar disc herniation (LDH).
Papers of randomized clinical trials (RCTs) concerning the effectiveness and safety of HSM therapy for LDH published in both Chinese and English before November 17, 2015 were collected from PubMed, EMBase, Cochrane library, CNKI, CBM, WanFang Data and VIP databases according to the inclusion and exclusion criteria and by using key words of "thermal moxibustion" "heat-sensitive acupoint" "lumbar intervertebral disc herniation (LIDH)" "lumbar disc herniation (LDH)" and "lumbago backache", followed by screening, data extracting and methodological quality assessing. Then, the Meta-analysis was performed using RevMan 5.3 software.
Twenty RCTs were included eventually, containing a total of 1 861 cases treated by HSM therapy in the treatment of LDH patients. The Meta-analysis shows that the effectiveness and safety of HSM therapy for LDH are superior to those of other therapies, which is drawn from total effective rate of treatment group[RR=1.13, 95%CI(1.09,1.18), <0.001], M-JOA score[MD=-3.17, 95%CI(-3.88, -2.47), <0.001], M-JOA score difference of various subgroups:daily life ability effect difference[MD=1.04, 95%CI(0.44, 1.64), <0.001], subjective effect symptoms difference[MD=0.58, 95%CI (0.23, 0.92),=0.001], objective effect symptoms difference[MD=1.12, 95%CI(0.58, 1.65),<0.001], VAS score[MD=-1.17,95%CI(-1.78, -0.57), <0.001], the recurrence rate[RR=0.54, 95%CI(0.37, 0.80), =0.002], and no adverse reactions mentioned in the reported results. The sensitivity analysis showed a greater homogeneity in literature and the results were stable, but funnel plot analysis showed a publication bias.
The HSM therapy is effective and safe in the treatment of LDH patients.
系统评价热敏灸疗法治疗腰椎间盘突出症（LDH）的有效性和安全性。
根据纳入和排除标准，通过使用关键词“热敏灸”“热敏穴位”“腰椎间盘突出症（LIDH）”“腰椎间盘突出症（LDH）”和“腰背痛”，从PubMed、EMBase、Cochrane图书馆、中国知网、中国生物医学文献数据库、万方数据和维普数据库中收集2015年11月17日前发表的关于热敏灸疗法治疗LDH有效性和安全性的随机临床试验（RCTs）论文，随后进行筛选、数据提取和方法学质量评估。然后，使用RevMan 5.3软件进行Meta分析。
最终纳入20项RCTs，共1 861例接受热敏灸疗法治疗的LDH患者。Meta分析显示，热敏灸疗法治疗LDH的有效性和安全性优于其他疗法，依据治疗组总有效率[RR=1.13，95%CI（1.09，1.18），<0.001]、改良日本骨科学会（M-JOA）评分[MD=-3.17，95%CI（-3.88，-2.47），<0.001]、各亚组M-JOA评分差值：日常生活能力效应差值[MD=1.04，95%CI（0.44，1.64），<0.001]、主观效应症状差值[MD=0.58，95%CI（0.23，0.92），=0.001]、客观效应症状差值[MD=1.12，95%CI（0.5
