悬吊运动疗法治疗慢性非特异性腰痛疗效的Meta分析

摘要

Objective To systematically review the clinical efficacy of sling exercise therapy(SET)on patients with chronic non-specif-ic low back pain (CNLBP). Methods Randomized controlled trials (RCT) about SET for CNLBP were electronically searched in CNKI, VIP,Wanfang Data,PubMed,Web of Science,The Cochrane Library and Embase from June,2007 to June,2017.After literatures screening, data extraction,quality evaluation and risk assessment,the results of meta-analysis were conducted by RevMan 5.3 software.Results Final-ly, 15 RCTs involving 789 patients were included. SET was better in improving Visual Analogue Scale (VAS) score (MD=-1.15, 95% CI[-1.41,-0.90],Z=8.82,P<0.00001)and Oswestry Low Back Pain Disability Index(ODI)score(MD=-1.29,95%CI[-1.80,-0.78],Z=4.94, P<0.00001) than physical therapy, and was better than other exercise therapies in improving the VAS score (MD=-0.94, 95% CI[-1.52,-0.37],Z=3.21,P=0.001)and ODI score(MD=-5.96,95%CI[-9.41,-2.51],Z=3.38,P=0.0007).However,no significant dif-ference was found in improving the NPRS score between SET and other exercise therapies(MD=0.35,95%CI[-0.23,0.93],Z=1.19,P=0.23),nor in improving VAS score between SET and traditional Chinese medical therapies(MD=-5.29,95%CI[-20.27,9.70],Z=0.69,P=0.49).Conclusion SET may play a role in relieving pain and functional limitations in patients with CNLBP.Due to the limited quantity and quality of the included studies,larger scale and high quality RCTs are needed to verify the aforementioned conclusion.%目的 探讨悬吊运动疗法治疗慢性非特异性腰痛(CNLBP)的临床疗效.方法 计算机检索2007年6月至2017年6月CNKI、维普数据库(VIP)、万方数据库、PubMed、Web of Science、The Cochrane Library及Embase,搜集悬吊运动疗法治疗CN-LBP的随机对照试验(RCT).对纳入文献进行筛选,资料提取,质量评价和风险评估后,采用RevMan 5.3软件进行Meta分析.结果 共纳入15个RCT,789例患者.悬吊运动疗法在改善视觉模拟量表(VAS)评分[MD=-1.15,95%CI(-1.41,-0.90),Z=8.82,P<0.00001]和Oswestry腰痛功能障碍指数评定量表(ODI)评分[MD=-1.29,95%CI(-1.80,-0.78),Z=4.94,P<0.00001]方面优于物理治疗;悬吊运动疗法在改善VAS评分[MD=-0.94, 95% CI(-1.52,-0.37), Z=3.21, P=0.001]和ODI评分[MD=-5.96, 95% CI (-9.41,-2.51),Z=3.38,P=0.0007]优于其他运动疗法,但悬吊运动疗法在改善疼痛数字评分量表(NPRS)评分方面与其他运动疗法无显著性差异[MD=0.35, 95% CI (-0.23, 0.93), Z=1.19, P=0.23];悬吊运动疗法在改善VAS评分方面与中医疗法无显著性差异[MD=-5.29,95%CI(-20.27,9.70),Z=0.69,P=0.49].结论 悬吊运动疗法在一定程度上可以改善患者疼痛和功能受限.因纳入文献数量有限及质量不高,上述确切结论仍需开展大样本高质量的RCT加以验证.