| Objective:The objective of this review was to evaluate all the randomized controlled trials,quasi randomized controlled trials of Rehabilitation therapy of traditional Chinese medicine in treating sciatica and review the efficiency and safety of Rehabilitation therapy of traditional Chinese medicine to treat sciatica.Methods:We drawed search strategy in accordance with the standards of the Cochrane Collaboration Handbook.We searched CBM(1978-2012), WanFangDate(l977-2012),VIP(1989-2013),CNKI(1993-2013),the Cochrane Library,MEDLINE(1966-2013).Included in the traditional Chinese medicine rehabilitation for sciatica randomized controlled and quasi-randomized controlled trials independently Set inclusion criteria, screening qualified research.Assessment of included studies,Total effective rate of curative effect, VAS and adverse reaction were assessed in this review.statistical analysis of the data by Revman5.2when less heterogeneity of the included studies for meta-analysis,or descriptive analysis.Using the odds ratio(OR), weighted mean value(WMD), standardized mean value(SMD) as Efficacy statistic.Results:3724published studies relateing to review were found, excluding3695,29studies(3019Patients).23trials is RCTs,6trials is quasi RCTs.most of the included trials were assessed quality of evidence are "low" or "very low". Meta-analysis or a descriptive analysis was adopted after extracting the data.(1)Total effective rate of curative effct:acupuncture was superior to western medicine(RR=1.23,95%CI 1.10,1.37); acupuncture combined with traditional Chinese medicine was superior to western medicind(RR=1.20,95%CI1.07,1.34); acupuncture combined with traditional Chinese medicine were superior to acupuncture alone(RR=1.27,95%CI1.09,1.49); acupuncture combined with massage were superior to acupuncture alone(OR=4.37,95%CI2.14～8.89); acupuncture combined with Frequency electrotherapy were superior to acupuncture alone(OR=3.76,95%CI1.04～13.65); Electr-needle combined with point injection were superior to the combination of traction and massage(OR=1.22,95%CI1.11～1.34); Acupoint Embedding, ultrashort wave therapy and western medicind were superior to the combination of ultrashort wave therapy and western medicind(OR=8.00,95%CI1.66～38.45); acupuncture combined with massage, traction and ultrashort wave therapy were superior to the combination of ultrashort wave therapy and traction(OR=5.57,95%CI1.47～21.08); Electr-needle, traction and low frequency current therapy were superior to the combination of traction and low frequency current therapy(OR=10.56,95%CI2.30～48.28).Also,no statistical difference was detected between Electr-needle and western medicine(OR=3.03,95%CI1.00～9.18); no statistical difference was detected between Electr-needle, point injection and Electr-needle(OR=7.64,95%CI0.92～63.73); no statistical difference was detected between acupuncture, pricking blood therapy and Electr-needle(OR=4.42,95%CI0.87～22.52); no statistical difference was detected between Canggui exploring point and acupuncture, Electr-needle(OR=2.60,95%CI0.49～13.81); no statistical difference was detected between needle warming moxibustion, cupping,TDP and Electr-needle, cupping,TDP (OR=2.36,95%CI0.41～13.73); no statistical difference was detected between massage, traction, traditional Chinese medicine fumigation and traction, massage(OR=2.25,95%CI0.62～8.18); no statistical difference was detected between acupuncture, traditional Chinese medicine, massage and acupuncture alone(OR=3.38,95%CI0.64～17.92); no statistical difference was detected between point injection, traditional Chinese medicine and western medicind(OR=1.70,95%CI0.61～4.73);About Electr-needle verse acupuncture, Because the author reports the two group total effective rate of the same, so we can not draw the curative effect of two groups.(2)VAS:acupuncture was not superior to Electr-needle (Ⅳ=1.22,95%CI1.00～1.45); acupuncture combined with physiotherapy was not superior to acupuncture alone(Ⅳ=1.24,95%CI0.22～2.27); Electr-needle combined with rehabilitation training was superior to rehabilitation training alone(Ⅳ=-1.01,95%CI-1.60～-0.42)Electr-needle combined with massage was superior to massage alone(IV=-1.46,95%CI-2.51～-0.41); abdominal acupuncture was superior to acupuncture(IV=-2.72,95%CI-4.83～-0.61); Electr-needle, traction and low frequency current therapy were superior to the combination of traction and low frequency current therapy(Ⅳ=-11.10,95%CI-11.58～-10.62); acupuncture, massage, raction combined with tultrashort wave therapy was superior to raction and tultrashort wave therapy (IV=-0.63,95%CI-1.21--0.05);The new Yi-Jin therapy,Fu’sSubcutaneousNeedling and acupuncture was superior to acupuncture alone(IV=-1.39,95%CI1.78～-1.00); no statistical difference was detected between Electr-needle and western medicine.Conclusion:There was insufficient reliable evidence for effectiveness of Rehabilitation therapy of traditional Chinese medicine in treating sciatica,the sample size is small,due to poor quality of trials, interventions and the diagnostic and evaluation criterias are not the same,reduce the reliability of the conclusions of study. Necessary to carry out more stringent design multi-center, large sample randomized controlled trials, the experimental evidence has been further confirmed. |
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