Chen Xuanwei, Zheng Zhizhan, Lin Jianhua
The First Affiliated Hospital of Fujian Medical University, Fujian, China.
Xianyou Country General Hospital, Fujian, China.
Front Pharmacol. 2022 Jun 6;13:859296. doi: 10.3389/fphar.2022.859296. eCollection 2022.
To systematically evaluate the clinical effectiveness of conservative treatments including pharmacological treatments and nonpharmacological treatments on patients with lumbar spinal stenosis. We searched six electronic databases systematically for randomized clinical trials published between January 2000 and July 2021, including the China National Knowledge Infrastructure, WanFang Data, PubMed, MEDLINE, Embase, and the Cochrane library. The studies focused on the therapeutic effects of pharmacological treatments including calcitonin, antiepileptics, neurotrophic drugs, nonsteroidal anti-inflammatory drugs, Chinese Traditional Medicine, limaprost, and nonpharmacological treatments like physiotherapy for treating lumbar spinal stenosis were included. The outcome was measured using the visual analog scale, Oswestry Dysfunction Index, Japanese Orthopaedic Association Score, and EuroQol Five Dimensions Questionnaire. The quality of eligible studies was assessed by using the Cochrane recommended bias risk assessment tool. Stata was used to conduct the network meta-analysis. A total of 12 randomized control trials with 1,194 patients were included. The network meta-analysis showed that for the visual analog scale, a better therapeutic effect was noted while using Chinese Traditional Medicine and physiotherapy, followed by analgesics drugs and limaprost. Limaprost and calcitonin were better in decreasing the Oswestry Dysfunction Index. In terms of the Japanese Orthopaedic Association Score, the use of traditional Chinese Medicine and limaprost were associated with a better improvement than other treatments. Meanwhile, limaprost combined with analgesics drugs was found to be effective to improve the EuroQol Five Dimensions Questionnaire. Among the commonly used conservative treatments for the treatment of lumbar spinal stenosis, limaprost may have better efficacy in improving the Japanese Orthopaedic Association Score and decreasing the Oswestry Dysfunction Index, with a beneficial effect on decreasing the visual analog scale and improving the EuroQol Five Dimensions Questionnaire. website, identifier registration number.
为系统评价包括药物治疗和非药物治疗在内的保守治疗对腰椎管狭窄症患者的临床疗效。我们系统检索了6个电子数据库，以查找2000年1月至2021年7月期间发表的随机临床试验，包括中国知网、万方数据、PubMed、MEDLINE、Embase和Cochrane图书馆。纳入的研究聚焦于药物治疗（包括降钙素、抗癫痫药、神经营养药物、非甾体抗炎药、中药、利马前列素）和非药物治疗（如物理治疗）对腰椎管狭窄症的治疗效果。采用视觉模拟量表、Oswestry功能障碍指数、日本矫形外科学会评分和欧洲五维健康量表对结局进行测量。使用Cochrane推荐的偏倚风险评估工具对符合条件的研究质量进行评估。采用Stata进行网状Meta分析。共纳入12项随机对照试验，涉及1194例患者。网状Meta分析表明，在视觉模拟量表方面，使用中药和物理治疗时疗效较好，其次是镇痛药和利马前列素。利马前列素和降钙素在降低Oswestry功能障碍指数方面效果较好。在日本矫形外科学会评分方面，使用中药和利马前列素比其他治疗的改善情况更好。同时，发现利马前列素联合镇痛药对改善欧洲五维健康量表有效。在腰椎管狭窄症常用的保守治疗中，利马前列素在改善日本矫形外科学会评分和降低Oswestry功能障碍指数方面可能具有更好的疗效，对降低视觉模拟量表评分和改善欧洲五维健康量表也有有益作用。网站，标识符注册号。
