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机械牵引作为腰椎间盘突出症物理治疗的临床疗效:一项荟萃分析

Clinical Efficacy of Mechanical Traction as Physical Therapy for Lumbar Disc Herniation: A Meta-Analysis.

作者信息

Wang Wenxian, Long Feibing, Wu Xinshun, Li Shanhuan, Lin Ji

机构信息

Department of Spinal Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, 570102 Hainan, China.

Department of Surgery, Hainan Cancer Hospital, Haikou, 570100 Hainan, China.

出版信息

Comput Math Methods Med. 2022 Jun 21;2022:5670303. doi: 10.1155/2022/5670303. eCollection 2022.

Abstract

OBJECTIVE

This study is aimed at exploring the clinical effect of mechanical traction on lumbar disc herniation (LDH).

METHODS

Related literatures were retrieved from PubMed, Medline, Embase, CENTRAL, and CNKI databases. Inclusion of literature topic was comparison of mechanical traction and conventional physical therapy for lumbar disc herniation. Jadad scale was used to evaluate the quality of the included RCT studies. The Chi-square test was used for the heterogeneity test, and a random effect model was used with heterogeneity. Subgroup analysis and sensitivity analysis were used to explore the causes of heterogeneity. If there was no heterogeneity, the fixed effect model was used, and funnel plots were used to test publication bias.

RESULTS

Visual analog scale (VAS) in the mechanical traction group was lower than that in the conventional physical therapy group (MD = -1.39 (95% CI (-1.81, -0.98)), = 6.56, and < 0.00001). There was no heterogeneity among studies (Chi = 6.62, = 0.25, and = 24%) and no publication bias. Oswestry disability index (ODI) in the mechanical traction group was lower than that in the conventional physical therapy group (MD = -6.34 (95% CI (-10.28, -2.39)), = 3.15, and = 0.002). There was no heterogeneity between studies (Chi = 6.27, = 0.18, and = 36%) and no publication bias. There was no significant difference in Schober test scores between the mechanical traction group and the conventional physical therapy group (MD = -0.40 (95% CI (-1.07, 0.28)), = 1.16, and = 0.25). There was no heterogeneity among studies (Chi = 1.61, = 0.66, and = 0%) and no publication bias.

CONCLUSION

Mechanical traction can effectively relieve lumbar and leg pain and improve ODI in patients with lumbar disc herniation but has no significant effect on spinal motion. The therapeutic effect of mechanical traction was significantly better than that of conventional physical therapy. Lumbar traction can be used in conjunction with other traditional physical therapy.

摘要

目的

本研究旨在探讨机械牵引对腰椎间盘突出症(LDH)的临床疗效。

方法

从PubMed、Medline、Embase、CENTRAL和CNKI数据库中检索相关文献。纳入文献主题为机械牵引与传统物理治疗对腰椎间盘突出症的比较。采用Jadad量表评估纳入的随机对照试验(RCT)研究的质量。采用卡方检验进行异质性检验,存在异质性时使用随机效应模型。采用亚组分析和敏感性分析探讨异质性的原因。若无异质性,则使用固定效应模型,并采用漏斗图检验发表偏倚。

结果

机械牵引组的视觉模拟评分(VAS)低于传统物理治疗组(MD = -1.39(95%CI(-1.81,-0.98)),Z = 6.56,P < 0.00001)。各研究间无异质性(Chi = 6.62,P = 0.25,I² = 24%)且无发表偏倚。机械牵引组的Oswestry功能障碍指数(ODI)低于传统物理治疗组(MD = -6.34(95%CI(-10.28,-2.39)),Z = 3.15,P = 0.002)。各研究间无显著异质性(Chi = 6.27,P = 0.18,I² = 36%)且无发表偏倚。机械牵引组与传统物理治疗组的Schober试验评分无显著差异(MD = -0.40(95%CI(-1.07,0.28)),Z = 1.16,P = 0.25)。各研究间无异质性(Chi = 1.61,P = 0.66,I² = 0%)且无发表偏倚。

结论

机械牵引可有效缓解腰椎间盘突出症患者的腰腿痛并改善ODI,但对脊柱活动度无显著影响。机械牵引的治疗效果明显优于传统物理治疗。腰椎牵引可与其他传统物理治疗联合使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8c/9239808/5d76e0714d9e/CMMM2022-5670303.001.jpg

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