手法治疗椎动脉型颈椎病临床随机对照试验的系统评价
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作者Author单位AddressE-Mail
郭凯 GUO Kai 上海中医药大学附属曙光医院石氏伤科医学中心 上海市中医药研究院骨伤科研究所,上海 200021 Medical Center of Orthopaedics, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 200021, China  
李林 LI Lin 上海中医药大学附属曙光医院石氏伤科医学中心 上海市中医药研究院骨伤科研究所,上海 200021 Medical Center of Orthopaedics, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 200021, China  
詹红生 ZHAN Hong-sheng 上海中医药大学附属曙光医院石氏伤科医学中心 上海市中医药研究院骨伤科研究所,上海 200021 Medical Center of Orthopaedics, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 200021, China shgsyjs@139.com 
王辉昊 WANG Hui-hao 上海中医药大学附属曙光医院石氏伤科医学中心 上海市中医药研究院骨伤科研究所,上海 200021 Medical Center of Orthopaedics, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 200021, China  
石印玉 SHI Yin-yu 上海中医药大学附属曙光医院石氏伤科医学中心 上海市中医药研究院骨伤科研究所,上海 200021 Medical Center of Orthopaedics, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 200021, China  
期刊信息:《中国骨伤》2012年,第25卷,第1期,第9-13页
DOI:10.3969/j.issn.1003-0034.2012.01.003
基金项目:“中医骨伤科学”国家重点学科(编号:100508);上海市科委重点项目(编号:09dZ1973800);国家重点基础研究发展计划(973)项目(编号:2007CB512701)、国家自然科学基金项目(编号:81073114、81001528)、上海市科委重点项目(编号:10495801100);上海市卫生局青年科研项目(编号:2010Y131);上海卫生局中医药科研专项(编号:2010QL012B,2010L027A)
中文摘要:

目的:评价手法治疗椎动脉型颈椎病的安全性、有效性,分析目前临床治疗现状。

方法:检索PubMed、OVID、Cochrane 图书馆、CBM、CNKI、VIP等数据库以及手工检索,共收集手法治疗椎动脉型颈椎病的文献265篇,中文文献251篇,英文文献14篇,其中5篇符合纳入研究标准,全部为中文文献;Cochrane 系统评价手册进行质量评价,并对5篇文献采用RevMan 4.2进行Meta分析

结果:纳入的5篇文献共736例患者。5篇文献的治愈率汇总合并OR为2.93,95% CI为[2.10,4.08];有效率汇总合并OR为3.99 ,95% CI为[2.47,6.44];手法对椎动脉型颈椎病的治愈率、有效率均明显优于其他疗法(除手法之外的治疗方法,如牵引、药物等)(P<0.01)。

结论:目前所纳入研究结果显示手法治疗椎动脉型颈椎病安全、有效,手法对椎动脉型颈椎病的治愈率、有效率明显优于其他疗法;但由于纳入文献的数量有限且质量不是很高,结论尚不确定,因此需要多中心的临床随机对照且长时间随访的试验,进一步验证。
【关键词】颈椎病  肌肉骨骼手法  随机对照试验
 
Systematic review of clinical randomized controlled trials on manipulation treatment for vertebral artery type of cervical spondylosis
ABSTRACT  

Objective: To evaluate the safety and efficacy of the manipulation treatment for vertebral artery type of cervical spondylosis and analyze the current status of clinical study.

Methods: To retrievie the PubMed,OVID,Cochrane library,CBM-disc database,CNKI database,VIP database,265 literatures of the manipulation treatment of vertebral artery type of cervical spondylosis were collected,including 251 literatures Chinese and 14 literatures English. Among the literatures,5 studies of Chinese literatures accorded with inclusion criteria. Cochrane systematic review was used to quality evaluation;and 5 studies were used RevMan 4.2 for Meta analysis of literature.

Results: Five documents included a total of 736 patients. Summary of the literature combined OR for the cure rate was 2.93,95% CI was [2.10,4.08]. Summary OR for the combined efficiency was 3.99,95% CI was [2.47,6.44]. Manipulation group's cure rate of vertebral artery type of cervical spondylosis was efficient and clearly superior to the other therapies. Expect of the manipulation,the traction and the drugs,hereinafter referred to as “other therapies”(P<0.01).

Conclusion: At present,documents included in this study have shown that manipulation treatment on vertebral artery type of cervical spondylosis is safe,both cure rate and the effective rate are much better than other therapies;but the incorporation of a limited number of documents and the quality is not very high,the conclusion is still uncertain,high-quality evidence should be needed to be further validated.
KEY WORDS  Cervical spondylosis  Musculoskeletal manipulations  Randomized controlled trials
 
引用本文,请按以下格式著录参考文献:
中文格式:郭凯,李林,詹红生,王辉昊,石印玉.手法治疗椎动脉型颈椎病临床随机对照试验的系统评价[J].中国骨伤,2012,25(1):9~13
英文格式:GUO Kai,LI Lin,ZHAN Hong-sheng,WANG Hui-hao,SHI Yin-yu.Systematic review of clinical randomized controlled trials on manipulation treatment for vertebral artery type of cervical spondylosis[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(1):9~13
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