Evaluation Of Internal Medicine Practices With The Treatment In Treating Orthopedic Lumbar Disc Herniation

[Background] Orthopedic lumbar disc herniation is common, frequently-occurring disease as the most common causes of low back pain, apart from a few required surgery, most advocates of conservative treatment. Practices internal medicine with the treatment of this disease has a good effect with the advantage of fewer side effects, are widely used in clinical,and now is the main method of conservative treatment. Medical literature for reports of its treatment of lumbar disc herniation does have good efficiency. Other clinical study of the present Law, the use of the master and not precise enough, to a certain extent affected the promotion of the conclusions of the study, therefore, systematic evaluation of these treatments it is very important, the use of evidence-based medicine and the methods of analysis of literature Meta-analysis of comprehensive data in order to promote traditional Chinese medicine into the world and modernization.[Objective] study the purpose of evaluation of the system in order to evidence-based medicine, systems analysis methods, evaluation of internal medicine practices with the treatment of lumbar disc herniation of the clinical efficacy and safety.[Methods] study published in the collection of domestic research with traditional Chinese medicine practices Oral treatment of lumbar disc herniation of the randomized controlled clinical efficacy literature. Document Retrieval Information:CJFD (CNKIWeb) (1979.1-2009.6), full-text database of Chinese scientific and technical journals (CQVIP) (1989-2009.6) and Wanfang full-text database of Chinese scientific (1999-2008). Inclusion criteria:inclusion criteria:(1) treatment group with the means for the treatment of internal medicine, the way the control group treatment and (or) treatment in conjunction with other clinical research. (2) study randomized controlled trial (RCT) or quasi-randomized controlled trials or claimed to be randomized controlled trials (whether or not the use of blind); groups better balanced, with comparative. (3) have a certain content of the study made statistical analysis of the samples. (4) efficacy of the standard choice of cure rate, efficiency indicators such as efficacy. The basis of clinical epidemiology/DME principles and methods, from randomized, balanced between groups, incorporated into the exclusion criteria, control, sample size, blinding, statistical method, subjects factor in the standardization of criteria for judging efficacy of nine areas, such as statistical analysis to calculate the percentage of all the circumstances, and to evaluate its quality. On this basis, the use of random effects model RevMan for Meta-analysis; of different standards into the sensitivity analysis results; by funnel plot analysis of publication bias.[Results] The total retrieval treatment of lumbar disc herniation of the3098 randomized controlled trial literature, there are 48 randomized controlled trials meet the inclusion criteria. The overall low-quality randomized, of which only three completely random.48 studies, the group balanced "comparable." In diagnostic criteria, the clear use of TCM and Western medicine have the diagnostic criteria for four, accounting for 8.33%, the use of TCM diagnostic criteria have five, accounting for 10.42%, Western diagnostic criteria used are 38, accounting for 79.17%; clearly into the standard seven, accounting for 14.58%; a clear exclusion criteria of 19, accounting for 39.58%. Study samples to establish non-precise Without a document described in the calculation of sample size, the distribution of occult and intention-to-treat analysis; blind study of the use of very small, only two blind method used (including a double-blind method, a single-blind method). The vast majority of the literature did not conduct statistical tests,38 (79.17%) the correct use of basic statistical methods, statistical methods are not a description of 27 persons, accounting for 56.25%.48 articles are studying Chinese medicine therapy, the trial of the standardization of medication to the drug composition, dosage form, dosage, usage, course of several aspects of the evaluation, the preliminary view that good for standardization of only three, accounting for 6.25%, bad for the standardization of 17, accounting for 35.42%, standardized for the general 28, accounting for 58.33%. 46 criteria for judging efficacy of literature, accounting for 95.83%; the use of practices for the control treatment were 29, accounting for 60.42%; the use of practices with western medicine for the control of 13, accounting for 27.08%. The two adverse reactions reported in the literature, accounting for 4.17%; 6 a suitable follow-up, accounting for 12.50%. Chinese medicine treatment (efficient) the effect of value (the pilot group and the control efficacy of the more than) OR=3.88,95% confidence interval CI [2.71,5.55].[Discussion] As Clinical Epidemiology/DME in clinical and research staff in the general push and has achieved great results. Practitioners of Chinese medicine to the quality of clinical research has been greatly improved, when the conduct of clinical research, the highest intensity of use of argumentation randomized controlled clinical trials (RCT), there are many problems, such as random allocation method, sample size estimates... and so on-. Should be strictly designed multi-center, large sample, randomized, double-blind, controlled, parallel placebo in clinical trials to provide more convincing evidence. The choice of indicators to determine efficacy, loss of visits and observation of adverse reactions, etc., clinical trials and other reports should be standardized. A small number of the study and the quality is not high, so the argument strength is weak, more high-quality research needed to increase the strength of argument.[Conclusion] After Meat analysis, internal medicine practices with the treatment of-prolapse of lumbar intervertebral disc certainly has some effect, but more quality with the best practices of Chinese medicine Oral treatment of lumbar disc herniation of the research papers there would enable the article. Causal relationship between the intensity of the argument more fully expect to see high-quality randomized controlled clinical literature on the number of the results of this study can be proven more of a progress.