Sun Kai, Zhu Li-Guo, Wei Xu, Yu Jie, Feng Min-Shan, Yin He, Liang Long, Zhang Yi-Li, Qi Bao-Yu
Wangjing Hospital of China Academy of Chinese Medical Sciences Beijing 100102, China Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine Beijing 100007, China.
Wangjing Hospital of China Academy of Chinese Medical Sciences Beijing 100102, China.
Zhongguo Zhong Yao Za Zhi. 2020 Mar;45(5):1159-1166. doi: 10.19540/j.cnki.cjcmm.20191011.501.
To evaluate the clinical efficacy and safety of Shentong Zhuyu Decoction in the treatment of lumbar disc herniation, in order to provide evidence for its clinical application. PubMed, Cochrane Library, EMbase, CNKI, WanFang, VIP, CBM and Clinical Trials.gov databases were sysmatically retrieved. Two researchers independently searched, screened and extracted data. Randomized controlled trials in line with the inclusion criteria were included in the study. The article quality was assessed with the bias risk tool in the Cochrane Handbook. Meta-analysis was performed using RevMan 5.3. A total of 604 articles were obtained from the retrieval, and 824 patients in 9 studies were finally selected through screening. The course of treatment was about 1 month, and all of the studies were completed in China. Meta-analysis showed that the efficacy of Shentong Zhuyu Decoction in the treatment of lumbar disc herniation was better than that of the control group(RR=1.19, 95%CI[1.12, 1.26], P<0.000 01), including the comparison with Yaotongning Capsules(RR=1.10, 95%CI[1.02, 1.19], P=0.01) and diclofenac sodium tablets(RR=1.26, 95%CI[1.11, 1.44], P=0.000 4). In VAS pain score, Shentong Zhuyu Decoction had also obvious advantages(MD=-3.70, 95%CI[-6.31,-1.09], P=0.005). In addition, the number of adverse events in the Shentong Zhuyu Decoction group was lower than that in the control group. Shentong Zhuyu Decoction can effectively alleviate discomfort symptoms of patients with LDH. It has an obvious clinical efficacy and less adverse reactions. However, restricted by the quality of the included literatures, prospective, multi-center, large-sample-size randomized controlled trials are still needed to further improve the clinical evidence of the effect of Shentong Zhuyu Decoction in the treatment of LDH.
为评价身痛逐瘀汤治疗腰椎间盘突出症的临床疗效和安全性，为其临床应用提供依据。系统检索PubMed、Cochrane图书馆、EMbase、中国知网、万方、维普、中国生物医学文献数据库及Clinical Trials.gov数据库。两名研究者独立进行检索、筛选和数据提取。纳入符合纳入标准的随机对照试验。采用Cochrane手册中的偏倚风险工具评估文章质量。使用RevMan 5.3进行Meta分析。检索共获得604篇文章，最终经筛选纳入9项研究中的824例患者。治疗疗程约1个月，所有研究均在中国完成。Meta分析结果显示，身痛逐瘀汤治疗腰椎间盘突出症的疗效优于对照组（RR=1.19，95%CI[1.12，1.26]，P<0.000 01），包括与腰痛宁胶囊比较（RR=1.10，95%CI[1.02，1.19]，P=0.01）及与双氯芬酸钠片比较（RR=1.26，95%CI[1.11，1.44]，P=0.000 4）。在视觉模拟评分法（VAS）疼痛评分方面，身痛逐瘀汤也具有明显优势（MD=-3.70，95%CI[-6.31，-1.09]，P=0.005）。此外，身痛逐瘀汤组不良事件发生例数低于对照组。身痛逐瘀汤可有效缓解腰椎间盘突出症患者的不适症状，具有明显的临床疗效且不良反应较少。然而，受纳入文献质量所限，仍需开展前瞻性、多中心、大样本量的随机对照试验，以进一步完善身痛逐瘀汤治疗腰椎间盘突出症疗效的临床证据。
