| Objective:1.To prove that Congrong Niuxi Decoction can relieve lumbar-leg pain in patients with Liver-Kidney deficiency type degenerative lumbar spinal stenosis,improve dysfunction,improve their quality of life,and the curative effect is not affected by the degree of spinal stenosis.2.From the perspective of evidence-based medicine,to prove that traditional Chinese medicine has good clinical efficacy and safety in patients with degenerative lumbar spinal stenosis.Methods:1.A total of 42 patients with Liver-Kidney deficiency type degenerative lumbar spinal stenosis were randomly divided into experimental group(42 cases)and control group(20 cases).Patients in 2 groups were given Celebrex tablets orally.In addition,the experimental group was treated with oral use of Congrong Niuxi Decoction.The treatment course of both groups was 4 weeks.The degree of stenosis was evaluated based on imaging data.Efficacy evaluation index including VAS score,ODI score,TCM syndrome score and total effective rate of treatment were used to evaluate the effectiveness.2.Randomized controlled trials with traditional Chinese medicine in treating degenerative lumbar spinal stenosis comprehensively searched in China National knowledge infrastructure(CNKI),Wanfang database,Chinese VIP database,Chinese Biomedical Literature Database(CBM),Pubmed,Web of science and Embase.The time frame range was from the establishment of the database to August 31,2020.Two researchers independently extracted data and evaluated the quality of literature.Review Manager 5.3 was selected to analysis the data.Results:1.There was no statistical difference in demographic data between the two groups of patients;2.After treatment,the VAS score and ODI score in the experimental group was significantly lower than that in the control group,the difference being significant(P<0.05);3.The TCM syndrome score,in the experimental group were lower than that in the control group,the difference being significant(P<0.05);4.After treatment,the total effective rate of treatment in the experimental group was 90.5%,higher than that(73.7%)in the control group,the difference being significant(P<0.05);5.Among 42 patients,the degree of stenosis was concentrated in grades 2 and 3.Correlation analysis of the experimental group showed that the Kendall rank correlation coefficient was r=0.237(P=0.249)and there was no significant correlation between the degree of stenosis and the efficacy;6.Meta analysis showed that compared with the control group,the treatment of degenerative lumbar spinal stenosis by traditional Chinese medicine not only significantly improved the efficiency of DLSS(RR=1.23,95%CI=[1.16,1.30],P<0.05),but also significantly improved VAS(MD=-1.88,95%CI=[-2.51,-1.25].P<0.05),JOA(MD=5.30,95%CI=[3.46,7.13],P<0.05)and ODI score(MD=-8.88,95%CI=[-17.06,-0.70],P<0.05).The hemorheological indexes of the observation group were improved more significantly,such as the whole blood high shear viscosity(MD=0.76,95%CI=[-1.09,-0.43],P<0.05),whole blood low shear viscosity(MD=-1.45,95%CI=[-2.29,-0.61],P<0.05)and fibrinogen(MD=-5.79,95%CI=[-7.50,-4.07],P<0.05)were lower than those of the control group.The microinflammatory state of the organism was ameliorated more significantly in the observation group,and the level of TNF-α(MD=-0.48,95%CI=[-0.53,-0.44],P<0.05)and CRP(MD=-8.30,95%CI=[-9.79,-6.81,P<0.05)were significantly reduced compared with the control group.There was no statistical difference in adverse reactions in patients(RR=0.34,95%CI=[0.06,1,89],P>0.05).Conclusion:1.Congrong Niuxi Decoction can relieve lumbar-leg pain in patients with Liver-Kidney deficiency type degenerative lumbar spinal stenosis,improve dysfunction,improve their quality of life,and have good safety.Its efficacy is not affected by the degree of spinal stenosis in patients.2.From the perspective of evidence-based medicine,it is proved that traditional Chinese medicine has good efficacy and safety in the treatment of patients with degenerative lumbar spinal stenosis. |
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