| Objective: By searching all major scientific research articles and counting all published articles on the randomized comparative clinical application of Huangqi Guizhi Wuwu Decoction in the treatment of cervical spondylotic radiculopathy from the establishment of the database to January 2022 on the network.Use the method of meta-analysis,to explore the clinical efficacy of Huangqi Guizhi Wuwu Decoction in the treatment of cervical spondylotic radiculopathy deply and to observe its impact on clinical evaluation indicators,to provide evidence-based basis for the clinical application of Huangqi Guizhi Wuwu Decoction in the treatment of cervical spondylotic radiculopathy.Methods:Using the network retrieval management system of our university library,take "Huangqi Guizhi Wuwu Decoction","random","control","cervical spondylotic radiculopathy",as subject words and keywords to carry out full-text retrieval in sequence in "CNKI","VIP","Wanfang full-text database","Sinomed" and "Pub Med" since the establishment of the database to January 2022.After reading the searched articles preliminarily,they will be screened according to the relevant inclusion criteria and exclusion criteria.The selected papers are introduced into the Cochrane evaluation system for quality evaluation.The clinical overall effective rate,pain visual analogue scale（VAS）score,cervical function score,TCM syndrome score and adverse reactions included in the literature were used as evaluation criteria.Put the data into the latest revman5.4 software for meta-analysis.Result:Through systematic search,207 literatures that may meet the inclusion requirements are preliminarily obtained after collecting various databases,including 49 in How Net,35 in VIP,55 in Wanfang,25 in Pub Med and 43 in sinomed.After integrating all the literatures,135 duplicate literatures were eliminated.The remaining articles were screened by reading the title and abstract of the articles.After deleting all 46 articles whose contents were obviously not suitable for the inclusion criteria,26 valuable literatures were obtained.After carefully reading the remaining papers,10 papers were excluded strictly according to the inclusion and exclusion criteria,and a total of 16 papers were obtained.According to statistics,there were 752 cases in the observation group and 719 Cases in the control group.Meta analysis shows:（1）clinical efficiency:The clinical effect of Huangqi Guizhi Wuwu Decoction on patients with CSR is better than that of Jingfukang Keli alone（RR=1.24,95%CI=[1.12,1.38];Z=4.02,P<0.0001）.Huangqi Guizhi Wuwu decoction combined with acupuncture and massage is more effective than acupuncture and massage alone in the treatment of CSR（Group acupuncture:RR=1.14,95%CI=[1.07,1.22];Group massage:RR=1.10,95%CI=[1.01,1.20];Z=2.28,P=0.02;Group acupuncture and massage:RR=1.19,95%CI=[1.12,1.27];Z=5.38,P<0.00001）.（2）VAS score:Huangqi Guizhi Wuwu decoction is more effective in relieving cervical pain symptoms in patients with CSR than Jingfukang Keli alone（MD=-1.29,95%CI=[-1.59,-0.99];Z=8.47,P<0.00001）.Huangqi Guizhi Wuwu decoction combined with acupuncture and massage is more effective than acupuncture and massage alone in relieving cervical pain in patients with CSR(Group acupuncture:MD=-1.22,95%CI=[-1.84,-0.61];Z=3.89,P<0.0001;Group acupuncture and massage:（MD=-2.23,95%CI=[-3.15,-1.31];Z=4.74,P<0.00001）.（3）Cervical function score:Huangqi Guizhi Wuwu decoction can effectively improve the functional activity of cervical spine in patients with CSR,and the curative effect of combined acupuncture and massage is better than that of simple acupuncture and massage（MD=5.46,95%CI=[1.58,9.33];Z=2.76,P=0.006）.（4）TCM syndrome score:in terms of "neck back shoulder arm pain",MD=-0.84,95%CI=[-1.51,-0.17];Z=2.45,P=0.01,the difference was statistically significant;in terms of "flaccidity syndrome",MD=-0.80,95%CI=[-1.37,-0.24];Z=2.78,P=0.005,the difference was statistically significant;in terms of "vertigo",MD=-1.23,95%CI=[-1.47,-0.98];Z=9.93,P<0.00001,the difference was statistically significant.Conclusion:（1）Huangqi Guizhi Wuwu decoction can significantly improve the total clinical effective rate in the treatment of CSR patients,which is better than the treatment of Jingfukang granule alone;Huangqi Guizhi Wuwu decoction combined with acupuncture and massage is more effective in the treatment of CSR than single application of acupuncture,massage or acupuncture and massage.（2）Huangqi Guizhi Wuwu decoction can more effectively alleviate the cervical pain symptoms of CSR patients,which is better than the treatment of Jingfukang granule alone.Huangqi Guizhi Wuwu decoction combined with acupuncture and massage is better than acupuncture and massage alone in improving cervical pain in patients with CSR.（3）Huangqi Guizhi Wuwu decoction can effectively improve the functional activity of cervical spine in patients with CSR,and the curative effect of combined acupuncture and massage is better than that of simple acupuncture and massage.（4）Huangqi Guizhi Wuwu decoction can effectively improve the main TCM Syndromes of patients with CSR,such as neck,back,shoulder and arm pain,flaccidity and vertigo,and the curative effect of combined acupuncture and massage is better than that of simple acupuncture and massage.（5）The adverse reaction rate of Huangqi Guizhi Wuwu Decoction in the treatment of CSR patients suggests that there is no significant difference in the adverse reaction rate between the observation group and the control group,which has no statistical significance.It can not explain that the side effects of Huangqi Guizhi Wuwu decoction are higher than those of the control group.Further comparative study of large sample size and high-quality literature is needed. |
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