机构:[1]The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China广东省中医院深圳市中医院深圳医学信息中心[2]Department of Anatomy and Histology & Embryology, Faculty of Basic Medical Science, Kunming Medical University, 1168 West Chunrong Road, Kunming, 650500, Yunnan, China[3]Department of Rehabilitation Medicine, Affiliated Haikou Hospital of Central South University Xiangya School of Medicine, Haikou, 570208, Hainan, China
Objective: To directly or indirectly compare the effectiveness and pain relief of TN combined with different treatments for lumbar disc herniation (LDH). Methods: The Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI), Wanfang data, Chinese Biomedical Literature database (CBM), Chinese Scientific Journal Database (VIP), PubMed, Embase, Cochrane library, and Web of Science were searched from inception to July 2020. Only full texts of randomized controlled trials (RCTs) that make comparisons between Tuina and Tuina combined with other methods were included. We extracted trial data and assessed the risk of bias by two reviewers independently. We pooled continuous data in standard mean differences (SMDs) and binary data in risk ratios (RRs), and provided 95% confidence intervals. The primary outcomes were the effectiveness rate. The secondary outcome was pain measurements including visual analog scale (VAS) scores. Results: Forty-four trials which included 4741 participants and 16 kinds of interventions were selected in our study. Tuina combined with Acupuncture was the most frequently investigated intervention. Five (31%) kindnesces (SMDs) and binary data in risk ratios (RRs), and provided 95% confidence intervals. The primary outcomes were the effectiveness rate. The secondary outcome was pain measurements including visual analog scale (VAS) scores. Results: Forty-four trials of treatments among 15 increased the healing rate more significantly compared with Tuina(TN), including Tuian combined with Traction and formula(TN + TRA + FM), Tuina combined with formula(TN + FM), Tuina combined with Traction and Acupuncture(ACU + TN + TRA), Tuian combined with Traction(TN + TRA), Tuina combined with Electroacupuncture(EA + TN), Tuina combined with the warm needle(TN + WN), Tuina combined with Acupuncture(ACU + TN). Seven treatments including Tuina combined with Electroacupuncture(EA + TN), Tuian combined with Traction and formula(TN + TRA + FM), Tuina combined with Acupuncture(ACU + TN), Tuina combined with formula(TN + FM), Acupuncture(ACU), Tuian combined with Traction(TN + TRA), Tuina combined with the warm needle(TN + WN) had better effects in reducing pain intensity compared with Tuina, range from 0.01 (95%Crl 0-0.08) for EA + TN to 0.30 (95%Crl 0.20-0.45) for TN + WN. Conclusions: According to the comprehensive review, Tuina combined with Traction and formula(TN + TRA + FM) seemed to be the most recommendable treatment which is more affordable and effective. However, all the available evidence was of low quality, so more high-quality studies are expected to confirm the effectiveness. Registration number: PROSPERO CRD42020193068.
基金:
This work was supported by (1) National Natural Science Foundation of China (Grant No. 81874511); (2) Guangdong Provincial Department of Finance Project [Grant (2016) No. 387]; (3) Innovation and Entrepreneurship Program for College Students of Guangzhou University of Chinese Medicine (Grant No. 201910572001; 201910572245; 202010572048; 202010572176).
第一作者机构:[1]The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
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通讯作者:
推荐引用方式(GB/T 7714):
Huang Fan,Xiao Zhaoxun,Zhan Xiaoxuan,et al.Tuina combined with Adjuvant therapy for lumbar disc herniation: A network meta-analysis[J].COMPLEMENTARY THERAPIES IN CLINICAL PRACTICE.2022,49:doi:10.1016/j.ctcp.2022.101627.
APA:
Huang, Fan,Xiao, Zhaoxun,Zhan, Xiaoxuan,Zeng, Ping,Zhao, Siyi...&Wu, Shan.(2022).Tuina combined with Adjuvant therapy for lumbar disc herniation: A network meta-analysis.COMPLEMENTARY THERAPIES IN CLINICAL PRACTICE,49,
MLA:
Huang, Fan,et al."Tuina combined with Adjuvant therapy for lumbar disc herniation: A network meta-analysis".COMPLEMENTARY THERAPIES IN CLINICAL PRACTICE 49.(2022)