脊髓型颈椎病的循证治疗研究现状

摘要

目的：推荐具有循证医学证据的脊髓型颈椎病的治疗、康复和护理方法，使患者能获得最佳的治疗和康复措施，最大限度地提高临床疗效。方法：采用计算机检索加手工检索的方法，检索相关指南、系统评价及 Meta 分析、临床随机对照试验、诊断治疗综述及流行病学研究；并由专人对检索文献进行评估，最后按传统医学证据体的构成及证据分级的建议证据等级进行推荐。结果：共检索出符合要求的文献14篇，其中采用保守治疗的有6篇，采用手术治疗的有8篇，经评价文献质量普遍较高，推荐等级为 A 级。结论：根据循证医学的方法，对治疗脊髓型颈椎病的临床方法进行证据等级评估，文中所列治疗方法均可推荐使用。文中所提供的证据可供初级保健医师、骨科医生、中医科医生和相关科室的医生及护士参考。%Objective:To recommend the standard evidence-based procedures of treatment,rehabilitation and nursing of cervical spondylotic myelopathy to patients so as to make sure they get the best treatment and rehabilitation,therefore to elevate clinical ef-ficacy.Methods:Computer retrieval and manual research were performed to ensure that all of the handbooks,guidelines,system reviews and Meta analysises,RCT,reviews about therapeutic methods and diagnoses and epidemiological studies related to cervical spondylotic myelopathy can be identified.The articles were evaluated and recommended according to the evidence-based traditional medicine system and suggestion of evidence grading.Results:This study included fourteen researches,and six of them reported a-bout conservative treatments and eight about surgeries.Evaluated to have high quality,all of the fourteen studies were recommen-ded as grade A articles.Conclusion:Evaluated by evidence-based method,the clinical treatment of cervical spondylotic myelopa-thy in the studies were graded and qualified to be recommended to adopt by primary care physicians,orthopedic surgeons,doctors of traditional Chinese medicine and related sections of the doctors and nurses as references.