基于雷达图分析中药内服治疗腰椎间盘突出症系统评价/Meta分析的文献质量
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摘要
目的:运用雷达图评估中药内服治疗腰椎间盘突出症的系统评价/Meta分析的文献质量,为其临床应用提供科学、有效的证据。方法:计算机检索自建库起至2018年10月1日中国知网、维普网、万方数据、中国生物医学数据库、PubMed、Cochrane图书馆、Embase收录的中药内服治疗腰椎间盘突出症系统评价/Meta分析的文献,对符合标准的文献进行资料提取后,从雷达图的6个方面(出版年份、设计类型、AMSTAR方法学质量评价、PRISMA报告学质量评价、同质性、发表偏倚风险)评价文献质量,并计算其秩数平均分。同时,采用Excel 2010、Adobe Illustrator CC等软件绘制并优化雷达图。结果:共纳入6篇合格文献,6个方面的秩数平均分分别为3.83、4.67、3.83、3.67、6.00、4.67分,所有项目的秩数平均分为4.56分。雷达图评价结果显示,质量较高的有2篇,质量偏低的有1篇,存在的主要问题在资料的选择偏倚、纳入与排除标准、发表情况、局限性、项目注册等方面。结论:中药内服治疗腰椎间盘突出症的系统评价/Meta分析文献质量仍有较大的提升空间,主要从加强方法学质量和报告学质量入手;雷达图为直观有效的图形化评价方法,值得推广应用。
OBJECTIVE:To evaluate the literature quality of systematic reviews/Meta-analysis of oral administration oftraditional Chinese medicine(TCM)in the treatment of lumbar disc herniation(LDH)using radar plot,and to provide scientificand effective evidence for clinical use of medicine. METHODS:Retrieving CNKI,VIP,Wanfang database,CBM,PubMed,Cochrane library and Embase during the establishement of database to Oct. 1 st,2018,the literatures about systematic reviews/Meta-analysis of oral administration of TCM in the treatment of LDH were collected. After data extraction of literatures met inclusioncriteria, the quality literatures were evaluated from 6 aspects of radar plot(year of publication, design type, AMSTARmethodological quality evaluation,PRISMA reprot quality evaluation,homogeneous,publication bias risk). The average score ofrank number was calculated. Moreover,Excel 2010,Adobe Illustrator CC and other software were used to draw and optimize theradar plot. RESULTS:A total of 6 qualified literatures were included;average score of rank number of 6 aspects were 3.83,4.67,3.83,3.67,6.00,4.67,scoring 4.56 in average. Multivariate evaluation of radar plot showed that 2 studies had higher qualities andonly 1 study had lower qualities relatively. However,problems could be found such as information selection bias,inclusion andexclusion criteria,publication situation,limitations,project registration. CONCLUSIONS:The literature quality of systematicreview/Meta-analysis of oral administration of TCM in the treatment of LDH need to be improved,starting with strengtheningmethodological quality and reporting quality. Radar plot is avisual and effective method of graphic evaluation,which isworth popularizing and applying in the future.
OBJECTIVE:To evaluate the literature quality of systematic reviews/Meta-analysis of oral administration oftraditional Chinese medicine(TCM)in the treatment of lumbar disc herniation(LDH)using radar plot,and to provide scientificand effective evidence for clinical use of medicine. METHODS:Retrieving CNKI,VIP,Wanfang database,CBM,PubMed,Cochrane library and Embase during the establishement of database to Oct. 1 st,2018,the literatures about systematic reviews/Meta-analysis of oral administration of TCM in the treatment of LDH were collected. After data extraction of literatures met inclusioncriteria, the quality literatures were evaluated from 6 aspects of radar plot(year of publication, design type, AMSTARmethodological quality evaluation,PRISMA reprot quality evaluation,homogeneous,publication bias risk). The average score ofrank number was calculated. Moreover,Excel 2010,Adobe Illustrator CC and other software were used to draw and optimize theradar plot. RESULTS:A total of 6 qualified literatures were included;average score of rank number of 6 aspects were 3.83,4.67,3.83,3.67,6.00,4.67,scoring 4.56 in average. Multivariate evaluation of radar plot showed that 2 studies had higher qualities andonly 1 study had lower qualities relatively. However,problems could be found such as information selection bias,inclusion andexclusion criteria,publication situation,limitations,project registration. CONCLUSIONS:The literature quality of systematicreview/Meta-analysis of oral administration of TCM in the treatment of LDH need to be improved,starting with strengtheningmethodological quality and reporting quality. Radar plot is avisual and effective method of graphic evaluation,which isworth popularizing and applying in the future.
引文
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[17]曾维仕,刘汝专,魏纪湖,等.活血化瘀类中药治疗腰椎间盘突出症有效性和安全性系统评价[J].湖南中医杂志,2017,33(1):123-128.
[18]陈臣,李宇卫,沈晓峰,等.中药治疗腰椎间盘突出症的Meta分析[J].山东中医杂志,2014,33(6):442-444.
[19]张旭桥.独活寄生汤治疗腰椎间盘突出症随机对照试验的系统评价[J].健康前沿,2017(2):272.
[20]陈新华,樊一桦,于臻.中药内服治疗腰椎间盘突出症的临床研究进展[J].天津中医药大学学报,2017,36(3):237-240.
[21]ZHANG B,XU HD,WANG JT,et al.A narrative review of non-operative treatment,especially traditional Chinese medicine therapy,for lumbar intervertebral disc herniation[J].Biosci Trends,2017,11(4):406-417
[22]LUO Y,HUANG J,XU L,et al.Efficacy of Chinese herbal medicine for lumbar disc herniation:a systematic review of randomized controlled trials[J].J Tradit Chin Med,2013,33(6):721-726.
[23]MA Y,CUI J,HUANG M,et al.Effects of Duhuojisheng Tang and combined therapies on prolapse of lumbar intervertebral disc:a systematic review of randomized control trails[J].J Tradit Chin Med,2013,33(2):145-155.
[24]孙之镐.中西医治疗骨折的理论与实践的差异与交融[J].中国骨伤,2009,22(3):208-211.
[25]高仲谋.自拟活血益气散结合微创治疗腰间盘突出的临床观察[J].中国伤残医学,2015,21(18):51-53.
[26]马彬.中医药临床研究方法与报告质量研究[D].兰州:兰州大学,2013.
[27]刘建平,夏芸.中文期刊发表的中医药系统综述或Meta-分析文章的质量评价[J].中国中西医结合杂志,2007,27(4):306-311.
[2]JORDAN J,KONSTANTINOU K.Herniated lumbar disc[J/OL].[2018-08-30].https://www.ncbi.nlm.nih.gov/pubmed/21711958.
[3]ZHANG J,ZHAO F,WANG FL,et al.Identification of lumbar disc disease hallmarks:a large cross-sectional study[J].Springer Plus,2016,5(1):1973.
[4]PETIT A.Low back pain,intervertebral disc and occupational diseases[J].Int J Occup Saf Ergon,2015,21(1):15-19.
[5]CHEN BL,GUO JB,ZHANG HW,et al.Surgical versus non-operative treatment for lumbar disc herniation:a systematic review and meta-analysis[J].Clin Rehabil,2018,32(2):146-160.
[6]THACKERAY A,FRITZ JM,LURIE JD,et al.Nonsurgical treatment choices by individuals with lumbar intervertebral disc herniation in the United States:associations with long-term outcomes[J].Am J Phys Med Rehabil,2017,96(8):557-564.
[7]CORNIOLA MV,TESSITORE E,SCHALLER K.Lumbar disc herniation:diagnosis and treatment[J].Rev Med Suisse,2014,10(454):2376-2382.
[8]SCHEIMAN JM.NSAID-induced gastrointestinal injury:a focused update for clinicians[J].J Clin Gastroenterol,2016,50(1):5-10.
[9]HARIRFOROOSH S,ASGHAR W.Adverse effects of nonsteroidal antiinflammatory drugs:an update of gastrointestinal,cardiovascular and renal complications[J].JPharm Pharm Sci,2013,16(5):821-847.
[10]PANESAR SS,RAO C,VECHT JA,et al.Development of the Radar plot and it’s application in cardiac surgery:an evidence synthesis graphic tool for the clinician to assess multiple meta-analyses reporting on a common outcome[J].Can J Surg,2009,52(5):E137-E145.
[11]熊俊,陈日新.系统评价/Meta分析方法学质量的评价工具:AMSTAR[J].中国循证医学杂志,2011,11(9):1084-1089.
[12]MOHER D,LIBERATI A,TETZLAFF J,et al.Preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement[J].Int J Surg,2010,8(5):336-341.
[13]方积乾.卫生统计学[M].7版.北京:人民卫生出版社,2015:175.
[14]李趣红,吴新贵,何源浩,等.中药治疗腰椎间盘突出症疗效的系统评价[J].广西医科大学学报,2013,30(6):904-907.
[15]马彦旭,张翔,孟开,等.独活寄生汤治疗腰椎间盘突出症随机对照试验的系统评价[J].中医杂志,2012,53(24):2095-2099.
[16]姜昆,刘晴晴,陶宝琛,等.补益肝肾、活血化瘀类中药复方治疗腰椎间盘突出症的Meta分析[J].中国药房,2016,27(36):5118-5122.
[17]曾维仕,刘汝专,魏纪湖,等.活血化瘀类中药治疗腰椎间盘突出症有效性和安全性系统评价[J].湖南中医杂志,2017,33(1):123-128.
[18]陈臣,李宇卫,沈晓峰,等.中药治疗腰椎间盘突出症的Meta分析[J].山东中医杂志,2014,33(6):442-444.
[19]张旭桥.独活寄生汤治疗腰椎间盘突出症随机对照试验的系统评价[J].健康前沿,2017(2):272.
[20]陈新华,樊一桦,于臻.中药内服治疗腰椎间盘突出症的临床研究进展[J].天津中医药大学学报,2017,36(3):237-240.
[21]ZHANG B,XU HD,WANG JT,et al.A narrative review of non-operative treatment,especially traditional Chinese medicine therapy,for lumbar intervertebral disc herniation[J].Biosci Trends,2017,11(4):406-417
[22]LUO Y,HUANG J,XU L,et al.Efficacy of Chinese herbal medicine for lumbar disc herniation:a systematic review of randomized controlled trials[J].J Tradit Chin Med,2013,33(6):721-726.
[23]MA Y,CUI J,HUANG M,et al.Effects of Duhuojisheng Tang and combined therapies on prolapse of lumbar intervertebral disc:a systematic review of randomized control trails[J].J Tradit Chin Med,2013,33(2):145-155.
[24]孙之镐.中西医治疗骨折的理论与实践的差异与交融[J].中国骨伤,2009,22(3):208-211.
[25]高仲谋.自拟活血益气散结合微创治疗腰间盘突出的临床观察[J].中国伤残医学,2015,21(18):51-53.
[26]马彬.中医药临床研究方法与报告质量研究[D].兰州:兰州大学,2013.
[27]刘建平,夏芸.中文期刊发表的中医药系统综述或Meta-分析文章的质量评价[J].中国中西医结合杂志,2007,27(4):306-311.