CAJ | 학술논문

目的：探讨针刀治疗腰椎间盘突出症的临床疗效，为临床实践提供循证医学证据。方法：全面检索CNKI（1989～2012年）、VIP（1989～2012年）、万方（1989～2012年）等数据库，收集针刀治疗腰椎间盘突出症的临床随机对照试验。经筛选，最终纳入符合标准的12篇文献作为Meta分析对象。用Co-chrane协作网免费提供的Review Manage5．0专用软件进行统计分析。结果：12项研究经Meta分析合并，结果显示，12项研究同质性检验结果，χ2＝4．65，自由度为11（P＝0．95＞0．1），表明12项研究具有同质性，故采用固定效应模式进行分析计算、汇总统计量。 OR合并后经Z检验：Z＝7．94（P＜0.00001），说明针刀和其他疗法相比，临床疗效的差异有统计学意义。结论：现有的临床证据表明，小针刀治疗腰椎间盘突出症疗效明显优于电针、推拿、牵引等疗法，但鉴于本研究纳入的方法学质量偏低、样本量有限，尚需要更多设计合理、执行严格的大样本、科学规范的高质量临床随机对照试验来进一步验证其临床疗效。
목적：탐토침도치료요추간반돌출증적림상료효，위림상실천제공순증의학증거。방법：전면검색CNKI（1989～2012년）、VIP（1989～2012년）、만방（1989～2012년）등수거고，수집침도치료요추간반돌출증적림상수궤대조시험。경사선，최종납입부합표준적12편문헌작위Meta분석대상。용Co-chrane협작망면비제공적Review Manage5．0전용연건진행통계분석。결과：12항연구경Meta분석합병，결과현시，12항연구동질성검험결과，χ2＝4．65，자유도위11（P＝0．95＞0．1），표명12항연구구유동질성，고채용고정효응모식진행분석계산、회총통계량。 OR합병후경Z검험：Z＝7．94（P＜0.00001），설명침도화기타요법상비，림상료효적차이유통계학의의。결론：현유적림상증거표명，소침도치료요추간반돌출증료효명현우우전침、추나、견인등요법，단감우본연구납입적방법학질량편저、양본량유한，상수요경다설계합리、집행엄격적대양본、과학규범적고질량림상수궤대조시험래진일보험증기림상료효。
Objective:To discuss the clinical curative effect of needle knife therapy on lumbar intervertebral disc protrusion and provide evidence -based medical evidence for clinical practice .Methods:Comprehensively search CNKI (1989~2012), VIP(1989~1989), Wanfang(1989~2012), such as database, collect clinical randomized controlled trials about needle knife in the treatment of lumbar intervertebral disc protrusion .After screening, finally 12 standard articles were found as Meta analysis objects .Use Review Manage5.0 specialized software Cochrane provided freely for statistical analysis .Results:12 researches by Meta analysis combined showed that 12 studies homogeneity test results , Chi square is 4 .65 , degrees of freedom was 11 ( P=0 .95>0.1 ) , and 12 studies had homogeneity ,so use the fixed effects model to analyze ,calculate and summarize statis-tics.ORcombinationchecked by Z∶Z=7.94(P<0.000 01), which suggested that needle knife compared with other treatments had a statistical significance .Conclusion:Current clinical evidence suggests that the curative effect of small needle knife therapy on lumbar intervertebral disc protrusion is better than electric acupuncture , massage , traction therapy .But with this research low methodological quality , limited sample size , it needs more large samples of reasonable design ,execution, strict, scientific and standardization ,and high quality clinical random-ized controlled trials are needed to further verify its effectiveness .