背景：腰椎间盘突出症（LDH），作为下背部疼痛最常见的原因之一，给患者和社会带来沉重的经济负担。保守治疗是大多数LDH患者的一线选择。中医是保守治疗的重要组成部分,越来越受到国际社会的重视。
方法：循证指南。
方法：我们成立了一个多学科专家指导小组。在系统的文献检索和共识会议的基础上确定了临床问题。我们搜索了有关LDH管理的直接证据的文献，并使用建议的分级来评估其确定性产生的建议，评估，发展,和评估(等级)方法。
结果：指南小组提出了20条建议，其中涵盖了神通逐瘀汤的使用，参浊汤,四妙散汤，独活寄生汤,腰必通胶囊,腰痛宁胶囊,ostoking,手动治疗,针刀,手工针灸,电针,中国运动技巧(太极拳，八段锦,或易进经)，和综合医学，如联合非甾体抗炎药，神经营养，和牵引力。建议不是强就是弱,或以未分级的基于共识的声明的形式。
结论：这是系统搜索的第一个中医和中西医结合治疗LDH的指南，综合证据，并采用等级法对证据质量进行评级。我们希望这些建议可以帮助支持医护人员照顾LDH患者。
BACKGROUND: Lumbar disc herniation (LDH), as one of the most common causes of lower back pain, imposes a heavy economic burden on patients and society. Conservative management is the first-line choice for the majority of LDH patients. Traditional Chinese medicine (TCM) is an important part of conservative treatment and has attracted more and more international attention.
METHODS: Evidence-based
guideline.
METHODS: We formed a
guideline panel of multidisciplinary experts. The clinical questions were identified on the basis of a systematic literature search and a
consensus meeting. We searched the literature for direct evidence on the management of LDH and assessed its certainty-generated recommendations using the grading of recommendations, assessment, development, and evaluation (GRADE) approach.
RESULTS: The
guideline panel made 20 recommendations, which covered the use of Shentong Zhuyu decoction, Shenzhuo decoction, Simiao San decoction, Duhuo Jisheng decoction, Yaobitong capsule, Yaotongning capsule, Osteoking, manual therapy, needle knife, manual acupuncture, electroacupuncture, Chinese exercise techniques (Tai Chi, Baduanjin, or Yijinjing), and integrative medicine, such as combined non-steroidal anti-inflammatory drugs, neural nutrition, and traction. Recommendations were either strong or weak, or in the form of ungraded
consensus-based statement.
CONCLUSIONS: This is the first LDH treatment guideline for TCM and integrative medicine with a systematic search, synthesis of evidence, and using the GRADE method to rate the quality of evidence. We hope these recommendations can help support healthcare workers caring for LDH patients.
PDF(Pubmed)