黄芪桂枝五物汤治疗神经根型颈椎病：一项随机对照试验的系统评价与Meta分析

Huangqi Guizhi Wuwu Decoction for treating cervical radiculopathy: A systematic review and meta-analysis of randomized controlled trials.

作者信息

Liang Long, Wei Xu, Feng Minshan, Zhu Liguo, Yu Jie, Yang Gongbo, Yin Xunlu, Zhou Shuaiqi, Li Kaiming, Yang Mao, Wang Xingyu

机构信息

Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences, Chaoyang District.

Department of Traumatology and Orthopedics, Xiyuan Hospital of Chinese Academy of Chinese Medical Sciences, Haidian District, Beijing.

出版信息

Medicine (Baltimore). 2020 Feb;99(7):e19137. doi: 10.1097/MD.0000000000019137.

BACKGROUND

Huangqi Guizhi Wuwu Decoction (HGWD) is a common prescription for the treatment of cervical radiculopathy (CR). And the effectiveness and safety of HGWD for CR were assessed in this study.

METHODS

Seven databases were searched. Randomized controlled trials involving HGWD alone or HGWD combined with conventional treatment were enrolled. The authors in pairs independently assessed the risk of bias and extracted the data.

RESULTS

Eight studies involving 783 participants with CR were included. Meta-analysis revealed that the efficacy of HGWD for CR was significantly superior compared with control treatment (risk ratio = 1.12, 95% confidence interval [CI]:1.06-1.19, Z = 3.71; P = .0002). Compare with control group, there is an increase in visual analog scale (mean difference [MD] = 0.99; 95% CI: 0.83-1.14; Z = 12.57; P < .00001). There was also an improvement of neck disability index (MD = 9.2; 95% CI: 8.28-10.11; Z = 19.75; P < .00001). Adverse events were not mentioned in the 8 trials.

CONCLUSION

HGWD alone or HGWD plus other treatment may be helpful to patients with CR. However, the methodological quality of the randomized controlled trials was generally low. Larger and better-designed randomized controlled trials are recommended.

背景

黄芪桂枝五物汤是治疗神经根型颈椎病（CR）的常用方剂。本研究评估了黄芪桂枝五物汤治疗神经根型颈椎病的有效性和安全性。

方法

检索了七个数据库。纳入单独使用黄芪桂枝五物汤或黄芪桂枝五物汤联合传统治疗的随机对照试验。作者双人独立评估偏倚风险并提取数据。

结果

纳入八项涉及783例神经根型颈椎病患者的研究。荟萃分析显示，与对照治疗相比，黄芪桂枝五物汤治疗神经根型颈椎病的疗效显著更优（风险比=1.12，95%置信区间[CI]：1.06-1.19，Z=3.71；P=0.0002）。与对照组相比，视觉模拟量表有所增加（平均差[MD]=0.99；95%CI：0.83-1.14；Z=12.57；P<0.00001）。颈部功能障碍指数也有所改善（MD=9.2；95%CI：8.28-10.11；Z=19.75；P<0.00001）。八项试验均未提及不良事件。