Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (21): 3401-3408.doi: 10.3969/j.issn.2095-4344.2613
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Xie Rui, Zhu Liguo, Yu Jie, Li Kaiming, Zhuang Minghui, Chang Xiaojuan, Dai Wenkang
Received:
2019-10-08
Revised:
2019-10-11
Accepted:
2019-11-07
Online:
2020-07-28
Published:
2020-04-18
Contact:
Zhu Liguo, MD, Chief physician, Doctoral supervisor, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
Yu Jie, MD, Chief physician, Doctoral supervisor, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
About author:
Xie Rui, MD candidate, Attending physician, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
Supported by:
CLC Number:
Xie Rui, Zhu Liguo, Yu Jie, Li Kaiming, Zhuang Minghui, Chang Xiaojuan, Dai Wenkang. Interpretation of American Osteopathic Association Guidelines for osteopathic manipulative treatment of nonspecific low back pain[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(21): 3401-3408.
4.1 整骨手法治疗急性和慢性非特异性下腰痛的疗效 10项研究分析了整骨手法对急性和慢性非特异性下腰痛疼痛的影响,包括12个对照组,1 141名参与者,见表2。其中6项研究表明整骨手法治疗对疼痛改善有显著影响[28,31-32,36,38,42];3项研究表明整骨手法对疼痛无显著影响[29-30,37];3项研究报告无显著影响[30,33,37],但对比对照组治疗有效。总体而言,有中等质量的证据表明,整骨手法治疗对疼痛缓解有显著影响(MD:-12.91;95%CI:-20.00至-5.82)。关于功能状态的数据,作者基于9项研究的结果,包含10个对照组和1 046名参与者。研究显示,中等质量的证据表明,支持整骨手法治疗的显著差异存在(SMD:-0.36;95%CI:-0.58至-0.14)。4项研究报告了整骨手法治疗的显著改善效 应[31-32,38,42],3项研究报告了不显著效应[28-29,33],2项研究报告了有利于对照组的不显著效应[30,37]。 "
4.2 整骨手法治疗慢性非特异性下腰痛的疗效 6项研究进行了7项对照,包含769名参与者[32-33,36-38,42],这一分析揭示中等质量的证据支持整骨手法治疗存在显著差异(MD:-14.93;95%CI:-25.18至-4.68)。对于功能状态的结果,3项研究报告了整骨手法治疗的显著改善[32,38,42];1项研究报告了整骨手法治疗的利于对照组的不显著效应[37]。综合来看,中等质量证据支持整骨手法治疗的显著差异(SMD:-0.32;95%CI:-0.58至 -0.07)。 4.3 整骨手法治疗非特异性下腰痛孕妇的疗效 对于妊娠期孕妇伴有下腰痛患者,FRANKE等[3]回顾了3项研究,包含4项对照,242名参与者,见表3。其中2项研究显示整骨手法治疗下腰痛有显著改善[34,39],另一项研究显示改善不显著[35]。这3项研究的最终分析表明,低质量的证据支持整骨手法治疗下腰痛(MD:-23.01;95%CI:-44.13至-1.88)和改善功能状态(SMD:-0.80;95%CI:-1.36至-0.23)。 "
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