| 李定艮,汪华琼,陈凤,吴慧敏,杨永红.健康教育对腰痛干预疗效的系统评价和Meta分析[J].中国康复,2020,35(5):262-268 |
| 健康教育对腰痛干预疗效的系统评价和Meta分析 |
| Effects of Health Education Program in Patients with Low Back Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials |
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| DOI： |
| 中文关键词: 腰痛 健康教育 meta分析 系统评价 |
| 英文关键词: low back pain health education meta-analysis systematic review |
| 基金项目:康复视角下颈椎病腰腿痛自我管理健康科普平台建设及应用研究（四川省科技厅项目资助，项目编号2017KZ0092） |
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| 中文摘要: |
| 目的:系统评价健康教育对腰痛患者疼痛、功能性活动及生活质量的临床效果。方法:计算机检索EMBASE、Web of Science、PubMed／Medline、The Cochrane Library、VIP 、CNKI和WanFang Data数据库，搜索时限从2009年1月~ 2019年9月。由两名评价员独立筛选文献、提取数据并评价纳入研究的方法学质量，以RevMan 5.3软件进行Meta分析。结果:最终纳入27个研究，共2701例患者。Meta 结果显示与对照组相比：①健康教育联合运动疗法在改善腰痛患者疼痛和功能障碍方面具有显著优势，NPRS评分［MD= -1.78，95%CI（-2.67，-0.89），P<0.01］、RMDQ评分［MD=-4.72，95%CI（-7.70，-0.84），P=0.01］；②健康教育联合常规治疗在改善疼痛方面并无显著性差异， VAS评分［ MD= -0.49，95%CI（-1.04，0.07），P=0.09］，但在改善功能障碍方面具有优势，RMDQ评分［MD= -0.97，95%CI（-1.91，-0.02），P=0.04］；③加强健康教育在疼痛改善方面具有优势， VAS评分［MD= -0.52，95%CI（-0.93，-0.11），P=0.01］、NPRS评分［MD= -0.41，95%CI（-0.75，-0.08），P=0.01］，在改善功能障碍方面均无优势。所有研究在改善生活质量方面均无优势。结论:运动疗法或常规治疗基础上增加健康教育更有利于腰痛患者疼痛缓解，并能更好的改善因腰痛导致的功能障碍。且加强健康教育可能更加有效。受纳入研究数量和质量的限制，以上述结论尚待更多高质量研究予以验证。 |
| 英文摘要: |
| Objective: To evaluate the clinical effects of health education program on pain, functional activities and quality of life in patients with low back pain. Methods: PubMed, Ovid Medline, EMBASE, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals and Wanfang Data were searched for any randomized controlled trials (RCTs) about the effect of health education program on patients with low back pain from Jan. 2009 to Sept. 2019. Two authors independently screened literature, extracted data and assessed the methodological quality of included studies. Meta-analysis was performed using RevMan 5.3 software. Results: A total of 27 RCTs involving 2701 patients were included. The results of meta analysis showed that, compared with the control group, health education combined with physical exercise ［NPRS: MD= -1.78, 95%CI (-2.67, -0.89), P<0.01］ and intensive health education could significantly relieve pain ［VAS: MD= -0.52, 95%CI (-0.93, -0.11), P=0.01］; (NPRS: MD= -0.41, 95%CI (-0.75, -0.08), P=0.01), but no significant difference was found when health education combined with conventional care for pain relieve (VAS: MD= -0.49, 95%CI (-1.04, 0.07), P=0.09). Health education combined with exercise therapy ［RMDQ: MD= -4.72, 95%CI (-7.70, -0.84), P=0.001］ and health education combined with usual care ［RMDQ: MD= -0.97, 95%CI (-1.91, -0.02), P=0.04］ could improve function activity, but intensive health education couldn’t improve function activity ［RMDQ: MD= 0.15, 95%CI (-0.74, 1.04), P=0.74］. Conclusion: The study suggests that health education combined with other treatments may have an advantage in relieving pain in patients with low back pain, and that intensive health education is more effective. |
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