论著

四子散中药封包药熨在股骨骨折患者术后疼痛及肿胀中的临床疗效及安全性

Clinical efficacy and safety of Sizi powder pack hot compress in postoperative pain and swelling of patients with femoral fracture surgery

:221-224
 
        目的 探究四子散中药封包药熨在股骨骨折术后疼痛及肿胀中的临床疗效及安全性。方法 选取2024年6月—2025年5月婺源县人民医院骨科收治的60例股骨骨折术后患者, 随机分为观察组(30例,常规治疗+四子散中药封包药熨)与对照组(30例,常规治疗)。比较两组治疗前后疼痛评分(NRS-11)、肿胀程度评分、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平及不良事件发生率。结果 治疗前两组患者疼痛、肿胀评分、CRP、IL-6水平比较差异无统计学意义(P>0.05); 治疗1周后,观察组疼痛评分为(2.11±0.48)分、肿胀程度为(0.35±0.43)度、CRP为(12.23±3.12)mg/L、IL-6为(16.03±4.01)ng/L,均低于对照组的(3.54±0.56)分、(1.04±0.58)度、(24.31±4.51)mg/L、(23.19±6.75)ng/L,差异有统计学意义(P<0.001)。观察组与对照组均无发生不良事件。结论 四子散中药封包药熨可缓解股骨骨折术后疼痛及肿胀,安全性良好。
       Objective To explore the clinical efficacy and safety of Sizi powder pack hot compress in the treatment of pain and swelling after femoral fracture surgery.Methods From June 2024 to May 2025, 60 patients after femoral fracture surgery were admitted to the Orthopedics Department of Wuyuan County People's Hospital and randomly divided into observation group(30 cases, conventional treatment+Sizi power pack hot compress)and control group(30 cases, conventional treatment). The pain score(NRS-11), swelling score, CRP,IL-6 levels and incidence of adverse events before and after treatment were compared between the two groups.Results There was no significant difference in pain and swelling scores between the two groups before treatment(P>0.05).After 1 week of treatment, the pain score(2.11±0.48), swelling score(0.35±0.43), CRP(12.23±3.12 mg/L), IL-6(16.03±4.01 ng/L)levels in the observation group were significantly lower than those in the control group(3.54±0.56, 1.04±0.58, 24.31±4.51 mg/L, 16.03+4.01 ng/L), and the difference was statistically significant(P<0.001).There were no adverse events in the observation group or the control group.Conclusions Sizi power pack hot compress can significantly alleviate the pain and swelling after femoral fracture surgery,and with good safety.
论著

广州番禺地区鹦鹉热衣原体肺炎的临床特征及疗效分析

Clinical characteristics and treatment efficacy of Chlamydia psittaci pneumonia in Panyu district of Guangzhou

:1574-1580
 
        目的   分析广州番禺地区鹦鹉热衣原体肺炎患者临床表现、实验室及胸部CT特征、并发症以及治疗方案,为其临床诊治提供参考。方法   回顾性分析2022年1月—2024年7月在广州市番禺区何贤纪念医院通过二代测序技术确诊的10例鹦鹉热感染患者的临床资料。结果  5例(5/10)患者有明确的鸟类或禽类接触史,8例(8/10)患者以发热为首发症状,发热(10/10)、咳嗽、咳痰(10/10)、呼吸困难(7/10)、相对缓脉(8/10)是主要临床表现。患者白细胞计数通常正常或轻微升高;多数患者存在有不同程度的电解质紊乱(10/10)及肝功能损伤(8/10)、乳酸脱氢酶升高(8/10),白蛋白显著降低(8/10)和C反应蛋白显著升高(10/10)。最常见的胸部CT异常为多肺叶受累的斑片状或片状实变,而重症患者多合并双侧胸腔积液。大多数患者经四环素或喹诺酮类单用,或者四环素联用β-内酰胺类抗菌药物治疗,预后良好。结论   有鸟类或禽类接触史、以发热为首发或主要症状、存在相对缓脉、白细胞计数升高不明显等临床特征可有助于区分鹦鹉热衣原体肺炎与其他传统细菌性肺炎,但这并不能确诊。二代测序技术是确诊鹦鹉热衣原体感染的很好方法,可以缩短诊断延误时间并改善患者预后。
       Objective  To describe the clinical,laboratory and chest CT characteristics as well as the complications and treatments of Chlamydia psittaci pneumonia patients in Panyu district of Guangzhou,to provide  reference for clinical diagnosis and treatment.Methods  A retrospective study was conducted on the clinical characteristics of Chlamydia psittaci pneumonia patients who were diagnosed by next-generation sequencing in Panyu Hexian Memorial Hospital of Guangzhou form January 2022 to July 2024.Results  Half patients had a definite history of bird or poultry exposure.Fever(100%),cough,sputum(100%),dyspnea(70%),relative bradycardia(80%)were the main clinical presentation.The total white cell counts were usually normal or slightly increased.Most patients had electrolyte disturbance(100%),liver function impairment(80%),lactic dehydrogenase increased(80%),albumin decreased(80%)and C reactive protein increased remarkably(100%).The most common chest CT abnormality was patchy or flaky hyper densities and consolidation,bilateral pleural effusion was common in severe patients.All patient exhibited good recovery after being treated with tetracycline or quinolone alone,or tetracycline in combination with other antibiotics.Conclusions  These characteristics may help distinguish Chlamydia psittaci pneumonia from other traditional bacterial pneumonia,but they are not definitive.Next-generation sequencing may be a promising approach to confirm Chlamydia psittaciinfection,which can shorten the diagnostic delay time and improve the prognosis of patients.
论著

脊髓损伤神经功能评估系统的优化和临床应用效果分析

Optimized design and clinical efficacy analysis of neural function evaluation system for spinal cord injury

:1415-1422
 
目的 优化纸质版脊髓损伤神经功能评估系统, 探讨其在脊柱脊髓损伤患者临床管理中的实际应用效果。方法 广泛检索国内外关于脊柱脊髓损伤患者神经运动功能评估的文献, 结合课题组成员的临床经验, 初步筛选出神经运动功能评估的关键项目。通过两轮德尔菲专家函询, 确定评估项目内容, 对纸质版脊髓损伤神经功能评估系统进行优化, 并进行临床应用验证。选取2021年8月1日—2023年5月31日在广州市第一人民医院脊柱外科住院的120例脊柱脊髓疾病患者作为研究对象, 随机分为观察组和对照组。对比两组在应用优化前后评估系统的神经功能评估准确性、评估所需时间以及临床应用便捷性等方面的差异。结果 观察组的评估准确性显著高于对照组,错评率由20.3%降至4.7%,漏评率由32.0%降至5.0%; 此外,优化后的评估系统显著缩短了评估时间,平均减少6.0 min, 有效提升了评估效率。结论 优化后的脊髓损伤神经功能评估系统显著提高了评估的准确性和效率, 有效减少了主观误差。
Objective To refine and optimize the paper-based assessment tool for evaluating neurological function in spinal cord injury patients, and to explore its impact on clinical practice.Methods A comprehensive review of existing literature on neuromotor function assessment in spinal cord injury patients was conducted, complemented by discussions among members of this study.This led to the integration of a preliminary evaluation framework.Subsequently, a two-round Delphi consensus process involving experts was undertaken to finalize the content of the assessment project.Based on this, a paper-based evaluation system was developed and converted into an electronic format by computer professionals.This system was then tested in a clinical setting, where it was administered to 120 spinal cord injury patients at the Spine Surgery Department of Guangzhou First People’s Hospital between 1 August 2021 and 31 May 2023.Patients were randomly assigned to either an experimental group or a control group, allowing for a comparison of accuracy, efficiency, and convenience in clinical application.Results The experimental group demonstrated a notable improvement in assessment accuracy over the control group, with a significant reduction in error rate from 20.3% to 4.7% and a decrease in omission rate from 32.0% to 5.0%.Furthermore, the average assessment time was shortened by 6.0 minutes, markedly enhancing the efficiency of the evaluation process.Conclusions The optimized neurological function assessment system for spinal cord injury patients has proven effective in enhancing both the accuracy and efficiency of assessments, while significantly minimizing subjective errors.This system holds considerable potential for widespread clinical adoption and application.
论著

PNF技术与居家康复联合治疗缺血性脑卒中患者的临床疗效

Clinical efficacy of PNF combined with home-based rehabilitation in patients with ischemic stroke

:1404-1408
 
目的 探究本体感觉神经肌肉促进疗法(PNF)技术与居家远程康复治疗对缺血性脑卒中患者凝血功能、平衡状态的影响。方法 选择2023年1月—2024年1月在宁乡市中医医院择期治疗的60例缺血性脑卒中患者为研究对象。按照患者选择的治疗方案进行分组, 观察组接受PNF技术联合居家远程康复指导治疗, 对照组接受常规居家远程康复指导治疗。记录疗效、凝血功能、神经功能缺损症状。结果 凝血功能方面,观察组治疗后活化部分凝血酶时间(APTT)、凝血酶原时间(PT)高于治疗前, 二聚体(D-D)、纤维蛋白原(FIB)低于治疗前,组间比较差异有统计学意义(P<0.05)。与对照组相比, 观察组的APTT、PT、D-D、FIB指标相近,组间比较差异无统计意义(P>0.05)。治疗后, 观察组平衡功能(BBS)评分比治疗前高, 组间比较差异有统计学意义(P<0.05)。观察组BBS评分、FMA评分、肌力等级更高, 组间比较差异有统计学意义(P<0.05)。结论 PNF技术+居家远程康复指导治疗可作为缺血性脑卒中患者治疗的有效手段。联合治疗后凝血功能、平衡状态、肢体功能状况、肌力明显改善, 可见联合治疗对于减轻患者病情尤为明显。
Objective To explore the effects of proprioceptive neuromuscular facilitation(PNF)and home-based remote rehabilitation on coagulation function and balance function in patients with ischemic stroke.Methods From January 2023 to January 2024, 60 patients with ischemic stroke were selected from our hospital.The patients were divided into two groups according to the treatment plan chosen by themselves.The patients in the observation group received PNF technology combined with home-based remote rehabilitation guidance, while the patients in the control group received routine home-based remote rehabilitation guidance.The curative effect, coagulation function and neurological deficit were recorded.Results After treatment, activated partial thrombin time(APTT)and prothrombin time(PT)were significantly higher, D-dimer(D-D)and fibrinogen(FIB)were significantly lower in the observation group than those before treatment(P<0.05).Compared with the control group, the APTT, PT, D-D and FIB of the observation group were similar, and there was no significant difference between the two groups(P>0.05).After treatment, the Berg Balance Scale score of the observation group was higher than that before treatment, and there was significant difference between the two groups(P<0.05).The Berg Balance Scale score, Fugl-Meyer Assessment score and muscle strength grade of observation group were higher than those of control group(P<0.05).Conclusions PNF combined with home-based remote rehabilitation can be used as an effective method for the treatment of patients with ischemic stroke.The coagulation function, balance, extremity function and muscle strength were significantly improved after combined treatment, which indicated that the combined treatment was especially effective in relieving the patients’ symptoms.
论著

伏诺拉生三联疗法治疗幽门螺杆菌的疗效观察

Efficacy of vonoprazan triple therapy for treatment of Helicobacter pylori

:489-493
 
目的 探究伏诺拉生三联疗法根除幽门螺杆菌(Hp)的疗效。方法 入组2022年5月—12月经13C尿素呼气试验确诊的Hp现症感染者200例,分为观察组和对照组,每组100例。观察组方案为阿莫西林、呋喃唑酮、伏诺拉生三联疗法,对照组方案为阿莫西林、呋喃唑酮、艾司奥美拉唑镁、枸橼酸铋钾四联疗法;疗程均为14 d。在治疗停药后1个月复查13C尿素呼气试验判定是否Hp根除成功,并观察药物不良反应发生率。结果 观察组Hp根除率为96.97%,高于对照组的89.80%,差异有统计学意义(P<0.05);观察组不良反应发生率和对照组比较差异无统计学意义(P>0.05)。结论 伏诺拉生、阿莫西林、呋喃唑酮三联疗法的Hp根除率较高且安全性良好,可作为Hp感染的治疗方案之一。
Objective To explore the effect of vonoprazan triple therapy on Helicobacter pylori(Hp).Methods A total of 200 patients with Hp infection confirmed by 13C urea breath test from May-December 2022 were selected and divided into observation group and control group with 100 patients in each group.The observation group was treated with triple therapy of amoxicillin,furazolidone and vonoprazan,while the control group was treated with quadruple therapy of amoxicillin,furazolidone,esomeprazole magnesium and bismuth potassium citrate.The treatment course was 14 days.The 13C urea breath test was reviewed one month after treatment withdrawal to determine whether Hp eradication was successful,and the incidence of adverse drug reactions was observed.Results The eradication rate of Hp in the observation group was 96.97%,higher than 89.80% in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusions The triple therapy of vonoprazan,amoxicillin and furazolidone has a very high eradication rate and good safety,which can be used as one of the treatment options for Hp.
论著

丙戊酸钠联合奥卡西平治疗癫痫对患者炎性因子及疗效的影响

To investigate the effect of sodium valproate combined with oxcarbazepine on inflammatory factors and efficacy in patients with epilepsy

:923-928
 
目的 探讨丙戊酸钠联合奥卡西平治疗癫痫的疗效及其对患者炎性因子的影响。方法 选择2022年1月—2023年1月医院接收的100例癫痫患者进行研究,电脑随机编号奇偶数分为两组各50例,对照组采取丙戊酸钠治疗,观察组采取丙戊酸钠联合奥卡西平治疗,评价并比较两组治疗效果、神经因子、炎症因子、免疫功能、认知功能及生活质量,观察不良反应发生率。结果 观察组和对照组的治疗有效分别为47例(94.00%)、39例(78.00%),观察组治疗有效率高于对照组(χ2=5.315,P=0.02)。治疗后,观察组的脑源性神经营养因子(195.33±18.29)pg/mL、神经生长因子(594.69±54.45)ng/mL水平高,肿瘤坏死因子-α(4.12±1.07)pg/mL、IL-1β(3.48±0.79)pg/mL、IL-6(53.44±3.63)pg/mL水平比对照组(150.68±15.27)pg/mL、(542.46±45.56)ng/mL、(6.35±1.27)pg/mL、(4.35±0.93)pg/mL、(63.02±3.81)pg/mL低(t=13.250、5.201、9.495、5.041、12.872,P<0.05)。治疗后,观察组的IgM(1.02±0.12)g/L、IgG(10.02±1.22)g/L、IgA(2.10±0.22)g/L比对照组(1.13±0.14)g/L、(11.68±1.57)g/L、(2.65±0.31)g/L更高(t=4.218、5.903、10.230,P<0.05)。治疗后,观察组的蒙特利尔认知量表(27.78±2.15)分、日常生活活动量表(71.88±6.45)分、癫痫患者生活质量评定量表-31(82.65±8.25)分比对照组(25.33±2.01)分、(65.65±5.54)分、(74.05±7.37)分更高(t=5.886、5.181、5.497,P<0.05)。观察组、对照组发生不良反应组间比较差异无统计学意义(χ2=1.010,0.343,1.010,1.010,1.010,P均>0.05)。结论 丙戊酸钠联合奥卡西平治疗癫痫患者可取得良好的疗效,控制癫痫症状,改善神经因子、认知功能,增强免疫功能,控制炎症因子,而且不良反应少,利于生活质量提高。
Objective To investigate the effect of sodium valproate combined with oxcarbazepine in the treatment of epilepsy and its influence on inflammatory factors.Methods From January 2022 to January 2023,100 patients with epilepsy admitted to our hospital were selected and randomly divided into two groups,50 cases in each group.The control group was treated with sodium valproate,and the observation group was treated with sodium valproate combined with oxcarbazepine.The therapeutic effect,neurological factors,inflammatory factors,immune function,cognitive function and quality of life were evaluated and compared between the two groups,and the incidence of adverse reactions was observed.Results The effective rate of the observation group and the control group were 94.00%(47 cases)and 78.00%(39 cases),respectively.The effective rate of the observation group was higher than that of the control group(χ2=5.315,P=0.02).After treatment,the levels of brain-derived neurotrophic factor(195.33±18.29)pg/mL and nerve growth factor(594.69±54.45)ng/mL in the observation group were higher than those in the control group.The levels of tumor necrosis factor-α(4.12±1.07)pg/mL,IL-1β(3.48±0.79)pg/mL,IL-6(53.44±3.63)pg/mL in the control group were(150.68±15.27)pg/mL,(542.46±45.56)ng/mL,(6.35±1.27)pg/mL,(4.35±0.93)pg/mL,(63.02±3.81)pg/mL(t=13.250,5.201,9.495,5.041,12.872,P<0.05). After treatment,the IgM(1.02±0.12)g/L,IgG(10.02±1.22)g/L,IgA(2.10±0.22)g/L were higher than those in the control group(1.13±0.14)g/L,(11.68±1.57)g/L,(2.65±0.31)g/L(t=4.218,5.903,10.230,P<0.05).After treatment,the scores of Montreal Cognitive Scale(27.78±2.15),Activities of Daily Living Scale(71.88±6.45)and Quality of Life in Epilepsy Scale 31(82.65±8.25)in the observation group were higher than those in the control group(25.33±2.01),(65.65±5.54)and(74.05±7.37)(t=5.886,5.181,5.497,P<0.05).There was no significant difference in adverse reactions between the observation group and the control group(χ2=1.010,0.343,1.010,1.010,1.010,all P>0.05).Conclusions Sodium valproate combined with oxcarbazepine in the treatment of patients with epilepsy can achieve good curative effect,control epilepsy symptoms,improve neurological factors,cognitive function,enhance immune function,control inflammatory factors,with less adverse reactions,conducive to improve the quality of life.
论著

内托生肌法治疗肉芽肿性乳腺炎溃后期的临床疗效

Clinical efficacy of endotropic muscle-generating therapy in treating late-stage ulcerative granulomatous mastitis

:888-894
 
目的 研究内托生肌法治疗肉芽肿性乳腺炎溃后期的临床疗效。方法 63例符合肉芽肿性乳腺炎溃后期的患者,分为西药组31例和中药组32例。西医药组予常规激素、抗生素等治疗,中药组予内托生肌法,加减组方,两组治疗时间为6个月。比较两组患者的疾病转归、乳房外形评价、临床症状观察评分等指标。结果 中药组6个月治愈率高于西药组,中药组临床治愈18例(56.2%)、痊愈11例(34.4%),相较于西药组临床治愈11例(35.5%)和痊愈9例(29%);治疗后中药组乳房外形评价优于西药组,中药组临床症状评分较低,组间比较差异具有统计学意义。两组患者治疗前后免疫球蛋白IgA、IgG、IgM水平比较差异均未见统计学意义。中药组相较于西药组不良反应更少,患者依从性更高。结论 内托生肌法治疗肉芽肿性乳腺炎溃后期能促进肉芽肿创面愈合,加快肉芽组织新生,改善破溃流脓症状以及在恢复乳房外观方面具有明显的优势。
Objective To study the clinical efficacy of endotropic muscle-generating therapy in treating late-stage ulcerative granulomatous mastitis.Methods Sixty-three eligible patients were included in the western medicine group(31 cases)and the traditional Chinese medicine group(32 cases).The western medicine group received conventional hormones and antibiotics,while the traditional Chinese medicine group received the endotropic muscle-generating method with adjustments.The treatment duration for both groups was six months.Disease regression,breast shape evaluation,clinical symptom observation scores,and other relevant indices of both groups were compared.Results The study found that the six-month cure rate in the traditional Chinese medicine group(56.2% clinically cured,34.4% cured)exceeded that of the western medicine group(35.5% clinically cured,29% cured).Breast appearance evaluation in the traditional Chinese medicine group significantly better that of the western medicine group post-treatment,and clinical symptom scores were lower,demonstrating a statistically significant difference.Before and after treatment,there was no significant difference in the levels of immunoglobulins A,G,and M observed between the two groups.The traditional Chinese medicine group exhibited fewer side effects and higher patient compliance compared to the western medicine group.Conclusions The endotropic muscle-generating method,when employed to treat granulomatous mastitis in the late ulcerative stage,proves effective in promoting granulomatous wound healing,accelerating the generation of new granulation tissue,and improving ulceration and pus flow symptoms.Additionally,it contributes to the restoration of breast appearance.
论著

GuideLiner®延长导管在复杂经皮冠状动脉介入治疗中的临床经验

Clinical efficacy and safety of GuideLiner® guide extension catheter application during complex coronary percutaneous coronary intervention procedure

:28-32
 
目的 总结GuideLiner®延长导管在复杂经皮冠状动脉介入治疗(PCI)中的初步经验,探讨其有效性及安全性。方法 选择2015年3月—2017年3月因冠心病于广州市第一人民医院行PCI的患者13例,因复杂病变需要更强支撑力而使用GuideLiner®延长导管完成手术,总结手术成功率、并发症以及6个月随访主要不良心脏事件的发生情况。结果 13例患者在GuideLiner®延长导管应用下均成功完成手术。使用延长导管的目的2例手术为辅助球囊通过,7例为辅助支架通过,4例为辅助支架及球囊通过。全部患者均未发生术中及住院期间死亡、急性心肌梗死,未发生急性支架内血栓形成、目标冠脉夹层或穿孔、心包填塞等并发症,6 个月随访均无不良心脏事件发生。结论 应用延长导管可提高支撑力,有效辅助球囊和/或支架到达冠状动脉病变部位,提高手术成功率,安全性较高。
Objective To evaluate the clinical efficacy and safety of GuideLiner® guide extension catheter during complex coronary percutaneous coronary intervention(PCI) procedures. Methods Thirteen patients with coronary heart diseases performed PCI procedures were included in this study from March 2015 to March 2017. GuideLiner® guide extension catheters were used in these complex cases. The PCI success rate,incidence of complications and 6-month follow up data were observed. Results Benefited from the stronger support produced by GuideLiner®, PCI success rate was 100%. The guide extension catheters were used for the delivery of balloons in 2 cases, while 7 cases for stents, and 4 cases for both balloons and stents. No death were observed during the procedure or in hospital, and there were no dissection or acute myocardial infarction. During 6 months of follow-up,there was no major adverse cardiac events (MACE). Conclusion GuideLiner® guide extension catheter may improve procedure success rate by ensuring the delivery of balloons and stents in complex PCI.
论著

AST、CHE、CA125、AFP对肝硬化患者的诊断效果分析

Analysis of diagnostic efficacy of AST,CHE,CA125 and AFP in patients with liver cirrhosis

:113-116
 
目的 分析谷草转氨酶(AST)、胆碱酯酶(CHE)、糖类抗原125(CA125)以及甲胎蛋白(AFP)对肝硬化患者的诊断效能。方法 选择70例肝硬化患者为观察组研究对象,另取70例同期健康体检者为对照组。两组研究对象均接受生化检验、肿瘤标志物检验。对比两组研究对象的AST、CHE、CA125、AFP检测结果,分析上述指标对肝硬化患者的诊断效能。结果 观察组肝硬化患者的CHE低于对照组,AST、CA125与AFP高于对照组(P<0.05);AST与CHE在肝硬化诊断中具有良好的灵敏度、特异度;CA125联合AFP的灵敏度、特异度、符合率均高于CA125或AFP单独检验(P<0.05)。结论 AST、CHE、CA125、AFP在肝硬化患者临床诊断中具有良好的应用表现,是反映患者肝硬化病情进展的重要参考指标。
Objective To analyze the diagnostic efficacy of aspartate aminotransferase(AST),cholinesterase(CHE),carbohydrate antigen 125(CA125),and alpha fetoprotein(AFP)in patients with liver cirrhosis.Methods A total of 70 patients with liver cirrhosis were included in the observation group as the study subjects,and 70 healthy individuals who underwent physical examinations during the same period were selected as the control group.Both groups of research subjects underwent biochemical testing and tumor marker testing.The AST,CHE,CA125,and AFP detection results of two groups of research subjects were compared,and the diagnostic effect of the above indicators on patients with liver cirrhosis were analyzed.Results The CHE test results of patients with liver cirrhosis in the observation group were significantly lower than those of healthy individuals undergoing physical examination,and the AST,CA125,and AFP test results were higher(P<0.05).AST and CHE had good sensitivity and specificity in the diagnosis of liver cirrhosis.The sensitivity,specificity and coincidence rate of CA125 combined with AFP were higher than those of CA125 or AFP alone.Conclusions AST,CHE,CA125,and AFP have good clinical application performance in the diagnosis of liver cirrhosis patients,and are important reference indicators reflecting the progression of liver cirrhosis in patients.
论著

不同针具在治疗腰椎间盘突出症的有效性与安全性的系统评估和网状Meta分析

A systematic assessment and network meta-analysis of the efficacy and safety of different needles in the treatment of lumbar disc herniation

:469-485
 
目的 评价现有关于干预组仅涉及不同针具针刺或联合常规针刺治疗腰椎间盘突出症系统评价的方法学质量,以比较不同针具针刺治疗腰椎间盘突出症的治疗效果。方法 通过CNKI(中国知网)、万方数据库、VIP(维普)、PubMed、Web of Science等数据库以及其他相关电子资源,对诊断、治疗腰椎间盘突出症的多种针灸技术进行全面的研究。使用AMSTAR2软件,对所有参与的系统性评估结果进行地分析,并根据不同的检测结果,确定文献筛选标准。通过Revman5.4和Cochrance风险偏倚工具,以及Stata16.0的网格Meta分析,挑选了3 381个满足纳入排除要求的随机对照试验。结果 以Stata 16.0统计软件制作排序图可知,杵针+电针的临床有效率SUCRA=81.6%排名第一;目测类比评分显示,银质针SUCRA(用于评估疗效的指标)=95%,排名第一。结论 根据现有的研究证据,杵针+电针以及银质针优于其他9种干预措施,但确切的结果仍需要大量的随机对照试验来证明。
Objective To evaluate the methodological quality of the existing systematic evaluation of the intervention group involving only different needle sets of acupuncture or combined with conventional acupuncture in the treatment of lumbar disc herniation,in order to compare the therapeutic effect of different needle sets of acupuncture in the treatment of lumbar disc herniation.Methods Through CNKI,Wanfang database,VIP,PubMed,web of science and other databases as well as other relevant resources,a variety of acupuncture techniques for the diagnosis and treatment of lumbar disc herniation were comprehensively studied.Through the use of AMSTAR2 software,all participating systematic evaluation results were effectively analyzed,and according to different test results,which literature meets the requirements were determined.Through revman5.4,Cochrane risk bias tool,and grid meta-analysis of stata16.0,3 381 RCTs meeting the inclusion and exclusion requirements were selected.Results According to the ranking chart made by stata16.0 statistical software,the clinical effective rate of pestle needle + electroacupuncture ranked first with sucra=81.6%.According to the visual analogy score,the silver needle sucra=95%,ranking first.Conclusions According to the existing research evidence,pestle needle + electroacupuncture and silver needle are better than the other nine interventions,but the exact results still need a large number of randomized controlled trials to prove.
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