A Systematic Review and Meta-analysis for Duhuo Jisheng Decoction Combined with Manipulation in Treatment of Lumbar Disc Herniation.

Objective: To systematically evaluate the efficacy and safety of Duhuo Jisheng decoction combined with manipulation in the treatment of lumbar disc herniation. Method:We systematically searched 8 databases at home and abroad. Literature quality of the included studies was evaluated by the bias risk assessment tool of Cochrane collaboration network, and the Meta-analysis was performed by RevMan 5.3 software. Result: A total of 427 related literature were retrieved, and 12 studies were eventually included, involving 1153 patients. All studies were in Chinese. Meta-analysis results showed that the total effective rate of Duhuo Jisheng decoction combined with manipulation in the treatment of LDH was better than that of the control group(RR= 1.23,95% CI [1.17,1.29],P < 0.00001). Subgroup analysis showed that Duhuo Jisheng decoction combined with manipulation had a more significant effect than conventional treatment(RR=1.34,95% CI [1.20,1.50],P< 0.00001), nonsteroidal anti-inflammatory drugs(RR=1.24,95% CI [1.12,1.37],P< 0.0001), and Yaotongning capsules(RR=1.19,95% CI [1.10,1.29],P< 0.0001). It has obvious advantages in improving VAS scores (MD= -1.19,95%CI -1.19 [-1.87,-0.51],P = 0. 0006), but it has no obvious advantages in improving JOA scores(MD= 2.65 95%CI [0.06,5.24]),P=0.05). In terms of safety, Duhuo Jisheng decoction combined with manipulation treatment reported fewer adverse events. Conclusion: The Duhuo Jisheng decoction combined with manipulation treatment can effectively relieve the clinical symptoms of patients with lumbar disc herniation, with obvious clinical efficacy, and fewer adverse events. But in view of the limitations of clinical studies, there are some limitations in this study, and more studies with high quality of evidence are needed to further confirm its efficacy and safety. [ABSTRACT FROM AUTHOR]