推拿治疗慢性非特异性下腰痛：系统评价与Meta分析方案

Tui Na for Chronic Nonspecific Low Back Pain: Protocol for a Systematic Review and Meta-analysis.

作者信息

Yang Juan, Brault Jeffrey S, Jensen Mark A, Do Alexander, Ma Qingyu, Zhou Xuan, Shen Longbin, Zhao Canghuan, Cheong Kwok Chee Philip, He Kejie, Guo Yu, Chen Zhuoming, Tang Shujie, Tang Yong, Tan Celia Ia Choo, Chen Jiaxu, Bauer Brent A

机构信息

Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States.

Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States.

出版信息

JMIR Res Protoc. 2021 Jan 27;10(1):e20615. doi: 10.2196/20615.

DOI:10.2196/20615

PMID:33502327

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7875686/

Abstract

BACKGROUND

Chronic nonspecific low back pain (CNLBP) is one of the most common complex pain conditions, and it is strongly associated with high rates of disability. Even though several studies on Tui na for CNLBP have been reported, to our knowledge there has been no systematic review of the currently available publications.

OBJECTIVE

This study aims to develop a protocol for a systematic review and meta-analysis that will evaluate the effectiveness and safety of Tui na therapy for patients with CNLBP.

METHODS

An electronic literature search of PubMed, Embase, MEDLINE, Cochrane Library, Springer, Scopus, World Health Organization International Clinical Trials Registry Platform, Physiotherapy Evidence Database (PEDro), Clarivate Analytics, and Chinese biomedical databases (the China National Knowledge Infrastructure, Wan-fang database, Chinese Scientific Journals Database, and Chinese Biomedical Literature Databases) will be conducted. Studies will be screened by two reviewers independently based on titles and abstracts, followed by a full-text reading with eligibility criteria. Randomized controlled trials involving Tui na for patients with CNLBP will be reviewed. The primary outcomes of the study are improvement of pain, analgesic medication reduction, improvement of functional disability, and degree of satisfaction with the intervention. A secondary outcome is any adverse event of Tui na intervention. Methodological quality and risk of bias will be assessed with the Cochrane Collaboration Risk of Bias Tool. If studies are sufficient, a meta-analysis of the effectiveness will be performed. If possible, we will evaluate publication bias using funnel plots. If substantial heterogeneity between studies is present, and there are sufficient studies, subgroup analyses will be conducted to explain the study findings.

RESULTS

The review database searches will be initiated in December 2020, with findings expected by January 2021.

CONCLUSIONS

This protocol will establish a framework of a high-quality literature synthesis on the impact of Tui na treatment in patients with CNLBP. The proposed review will determine whether Tui na is effective and safe for CNLBP patients.

TRIAL REGISTRATION

PROSPERO CRD42020166731; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=166731.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/20615.

摘要

背景

慢性非特异性下腰痛（CNLBP）是最常见的复杂疼痛病症之一，且与高致残率密切相关。尽管已有多项关于推拿治疗CNLBP的研究报道，但据我们所知，目前尚无对现有文献的系统评价。

目的

本研究旨在制定一项系统评价和荟萃分析方案，以评估推拿疗法对CNLBP患者的有效性和安全性。

方法

将对PubMed、Embase、MEDLINE、Cochrane图书馆、Springer、Scopus、世界卫生组织国际临床试验注册平台、物理治疗证据数据库（PEDro）、科睿唯安分析以及中国生物医学数据库（中国知网、万方数据库、中国科学期刊数据库和中国生物医学文献数据库）进行电子文献检索。研究将由两名审稿人根据标题和摘要独立筛选，随后进行符合纳入标准的全文阅读。将对涉及推拿治疗CNLBP患者的随机对照试验进行综述。本研究的主要结局是疼痛改善、镇痛药物减少、功能障碍改善以及对干预措施的满意度。次要结局是推拿干预的任何不良事件。将使用Cochrane协作偏倚风险工具评估方法学质量和偏倚风险。如果研究足够多，将对有效性进行荟萃分析。如果可能，我们将使用漏斗图评估发表偏倚。如果研究之间存在实质性异质性，且研究数量充足，将进行亚组分析以解释研究结果。