脊柱手法治疗对慢性非特异性颈痛干预效果的Meta分析

doi:10.3969/j.issn.1006-9771.2022.02.004

Abstract

Abstract:

Objective To evaluate the effects of spinal manipulation therapy (SMT) on chronic nonspecific neck pain (CNSNP) by using World Health Organization Family International Classifications (WHO-FICs). Methods Randomized controlled trials (RCTs) about the effects of SMT on CNSNP were searched from PubMed, Web of Science, Cochrane Library, EMBASE, EBSCO, CBM and CNKI from database establishment to December 31st, 2021. At least two researchers extracted the data. Cochrane bias risk assessment tool and Physiotherapy Evidence Database Scale were used to evaluate the quality of the included articles. Revman 5.4 software and Stata 16.0 software were used for meta-analyses and publication bias analysis respectively. Results A total of 15 RCTs that represented 1 067 participants were evaluated. In terms of body functions, compared with the control group, SMT significantly reduced Visual Analog Score for pain (MD = -0.85, 95%CI -1.06 to -0.63, P < 0.00001) and Numerical Rating Scale (MD = -0.92, 95%CI -1.29 to -0.55, P < 0.001), increased pressure pain thresholds (SMD = 0.67, 95%CI 0.47 to 0.86, P < 0.001), cervical range of motion (ROM) of flexion/extension (SMD = 0.51, 95%CI 0.33 to 0.68, P < 0.001) and rotation (SMD = 0.20, 95%CI 0.01 to 0.38, P = 0.04), improved root mean square of cervical muscles electromygraphy (MD = 2.17, 95%CI 0.06 to 4.29, P = 0.04), but not significantly in cervical ROM of lateral flexion (SMD = 0.19, 95%CI -0.00 to 0.38, P = 0.06), cervical strength (SMD = -0.18, 95%CI -0.84 to 0.49, P = 0.60) and endurance (SMD = 0.18, 95%CI -0.39 to 0.75, P = 0.53). In term of activities and participation, SMT significantly improved cervical disability (MD = -0.96, 95%CI -1.55 to -0.38, P = 0.001), but not significantly in health status of patients with CNSNP (SMD = 0.08, 95%CI -0.03 to 0.20, P = 0.15). Conclusion SMT could improve pain intensity, pain sensitivity, cervical ROM and disability in patients with CNSNP, but its efficacy on muscle function, proprioception and health status is unclear.

Key words: nonspecific chronic neck pain, spinal manipulation therapy, World Health Organization Family International Classifications, meta-analysis

CLC Number:

R681.5

ZHENG Wei,SUN Libing,HAO Chuanping,HUANG Wenqi,YOU Jing,GUO Yanhua. Effect of spinal manipulation therapy on chronic nonspecific neck pain: a meta-analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(2): 150-164.

Figures/Tables 20

纳入文献	干预措施			疗程	评定时间	主要ICF类目	结局指标	不良反应
纳入文献	试验组	SMT对应ICHI编码	对照组	疗程	评定时间	主要ICF类目	结局指标	不良反应
罗慧等^[18](2021)	SMT(4R技术)	MBA.PA.ZZ	中、高频电治疗	每次20 min/次,每周2次,共2周	干预前、干预2周后	b2801、b710、b730、d899	①④⑦⑨⑩	无
Aki等^[19](2020)	SMT(diversified技术)	MBG.PA.ZZ	干针疗法	每周2次,共4周	干预前、干预4周后	b2801、b710、d899	①④⑦	无
Akhter等^[20](2014)	SMT(HVLA技术)+ET	MBA.PA.ZZ	ET	SMT：每周2次,共3周 ET：每天2次,每周7 d,共3周	干预前、干预3周后	b2801、d899	①④	无
Galindez-Ibarbengoetxea等^[21](2018)	SMT(HVLA技术)	MAJ.PA.ZZ、MBA.PA.ZZ或MBG.PA.ZZ	HE	SMT：单次 HE：每天10~20 min,共7 d	干预前、干预1周后	b2801、b710、b730、d899	①③④⑦⑨	无
Lee等^[22](2016)	SMT(HVLA技术)+DCF训练	MBG.PA.ZZ	DCF训练	每次35 min,每周3次,共10周	干预前、干预10周后	b2801、b710、b740	①④⑦⑧?	无
Martel等^[23](2011)	SMT(HVLA技术)	MBA.PA.ZZ或MBG.PA.ZZ	空白对照	共10~15次,共5~6周	干预前、干预5~6周后	b2801、b710、d899、d5702	①④⑥⑦	无
Murphy等^[24](2010)	前4周：SMT(HVLA技术) 后8周：SMT(HVLA技术)+ET	MBA.PA.ZZ或MBG.PA.ZZ	前4周：空白对照后8周：ET	SMT：每周1~2次 ET：每周3次,共8周	干预前、干预4周和12周后	b2801、d899	①④	无
Palmgren等^[25](2006)	SMT(HVLA技术)+HE	MBA.PA.ZZ或MBG.PA.ZZ	HE	共3~5次,共5周	干预前、干预5周后	b710	⑦	无
Valera-Calero等^[26](2019)	SMT(HVLA技术)	MBA.PA.ZZ	组1：关节松动组2：假治疗	单次	干预前、单次干预后	b2801、b710、b599、d899	①③④⑦	无
García-Pérez-Juana等^[27](2018)	组1：右侧SMT(HVLA技术) 组2：左侧SMT(HVLA技术)	MBA.PA.ZZ	假治疗	单次	干预前、单次干预和干预1周后	b2801、d899、d429	②③④?	无
Bronfort等^[15](2004)	组1：SMT(HVLA技术)+ET 组2：SMT(HVLA技术)	MBA.PA.ZZ或MBG.PA.ZZ	ET	每次1 h,共20次,共20周	干预前,干预11周后	b2801、b730、b740、d899、d5702	②④⑤⑧?	无
Evans等^[28](2012)	SMT(HVLA技术)+ET	MBA.PA.ZZ或MBG.PA.ZZ	ET	每次15~20 min,共20次,共12周	干预前,干预12周后	b2801、d899、d5702	②④⑤	无
Lau等^[29](2011)	SMT(A-P技术)+IRR	MBG.PA.ZZ	IRR	每周2次,共4周	干预前,干预4周后	b2801、b710、s710	②⑤⑦?	无
Maiers等^[30](2014)	SMT(diversified技术)+HE	MBA.PA.ZZ	HE	共20次,共12周	干预前,干预12周后	b2801、d899、d5702	②④⑤	无
Mansilla-Ferragut等^[31](2009)	SMT(HVLA技术)	MAJ.PA.ZZ	安慰剂治疗	单次	干预前,干预5min后	b2801	③	无

References 48

[1]	GÓMEZ F, ESCRIBÁ P, OLIVA-PASCUAL-VACA J, et al. Immediate and short-term effects of upper cervical high-velocity, low-amplitude manipulation on standing postural control and cervical mobility in chronic nonspecific neck pain: a randomized controlled trial[J]. J Clin Med, 2020, 9(8): 2580-2597. doi: 10.3390/jcm9082580
[2]	SAFIRI S, KOLAHI A A, HOY D, et al. Global, regional, and national burden of neck pain in the general population, 1990-2017: systematic analysis of the Global Burden of Disease Study 2017[J]. BMJ, 2020, 368(3): 791-801.
[3]	ERDEM E U, ÜNVER B, AKBAS E, et al. Immediate effects of thoracic manipulation on cervical joint position sense in individuals with mechanical neck pain: a randomized controlled trial[J]. J Back Musculoskelet Rehabil, 2021, 34(5): 735-743. doi: 10.3233/BMR-191798
[4]	GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396(10258): 1204-1222. doi: 10.1016/S0140-6736(20)30925-9
[5]	黄梅忠, 王诗忠. 慢性非特异性颈痛的治疗现状[J]. 中国康复医学杂志, 2021, 36(9): 1190-1194.
	HUANG M Z, WANG S Z. Current state of treatment of chronic non-specific neck pain[J]. Chin J Rehabil Med, 2021, 36(9): 1190-1194.
[6]	郑尉, 宋皓, 孙立冰, 等. 颈椎手法干预对高校短跑运动员部分专项素质和动态平衡能力的影响[J]. 北京体育大学学报, 2021, 44(8): 101-112.
	ZHENG W, SONG H, SUN L B, et al. Effects of cervical manipulation therapy on collegiate sprinters' partial specific competencies and dynamic balance ability[J]. J Beijing Sport Univ, 2021, 44(8): 101-112.
[7]	GEVERS-MONTORO C, PROVENCHER B, DESCARREAUX M, et al. Neurophysiological mechanisms of chiropractic spinal manipulation for spine pain[J]. Eur J Pain, 2021, 25(7): 1429-1448. doi: 10.1002/ejp.v25.7
[8]	BRYANS R, DECINA P, DESCARREAUX M, et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain[J]. J Manipulative Physiol Ther, 2014, 37(1): 42-63. doi: 10.1016/j.jmpt.2013.08.010
[9]	BIER J D, SCHOLTEN-PEETERS W G M, STAAL J B, et al. Clinical Practice Guideline for physical therapy assessment and treatment in patients with nonspecific neck pain[J]. Phys Ther, 2018, 98(3): 162-171. doi: 10.1093/ptj/pzx118
[10]	KJAER P, KONGSTED A, HARTVIGSEN J, et al. National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy[J]. Eur Spine J, 2017, 26(9): 2242-2257. doi: 10.1007/s00586-017-5121-8
[11]	邱卓英, 李伦, 陈迪, 等. 基于世界卫生组织国际健康分类家族康复指南研究:理论架构和方法体系[J]. 中国康复理论与实践, 2020, 243(2): 125-135.
	QIU Z Y, LI L, CHEN D, et al. Research on rehabilitation guidelines using World Health Organization Family International Classifications: framework and approaches[J]. Chin J Rehabil Theory Pract, 2020, 243(2): 125-135.
[12]	王楚怀, 王宏图, 叶超, 等. 颈椎病康复专家共识[M]//中华医学会物理医学与康复学会, 岳寿伟, 何成奇. 物理医学与康复学指南与共识. 北京: 人民卫生出版社, 2019: 126-153.
	WANG C H, WANG H T, YE C, et al. Expert consensus of cervical diseases [M]// Chinese Society of Physical Medicine and Rehabilitation, YUE S W, HE C Q. Guidelines and Consensus for Physical Medicine and Rehabilitation. Beijing: People's Medical Publishing House, 2019: 126-153.
[13]	SUVARNNATO T, PUNTUMETAKUL R, UTHAIKHUP S, et al. Effect of specific deep cervical muscle exercises on functional disability, pain intensity, craniovertebral angle, and neck-muscle strength in chronic mechanical neck pain: a randomized controlled trial[J]. J Pain Res, 2019, 12: 915-925. doi: 10.2147/JPR
[14]	谷鸿秋, 王杨, 李卫. Cochrane偏倚风险评估工具在随机对照研究Meta分析中的应用[J]. 中国循环杂志, 2014, 29(2): 147-148.
	GU H Q, WANG Y, LI W. The application of the Cochrane bias risk assessment tool in the meta-analysis of randomized controlled trials[J]. Chin Circ J, 2014, 29(2): 147-148.
[15]	BRONFORT G, HAAS M, EVANS R L, et al. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synjournal[J]. Spine J, 2004, 4(3): 335-356. doi: 10.1016/j.spinee.2003.06.002
[16]	刘关键, 吴泰相. 循证医学中统计指标的正确应用[J]. 中国临床康复, 2003, 7(3): 359-362, 365.
	LIU G J, WU T X. Correct application of statistical indicators in evidence-based medicine[J]. Chin J Clin Rehabil, 2003, 7(3): 359-362, 365.
[17]	CUMPSTON M, LI T, PAGE M J, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions [J]. Cochrane Database Syst Rev, 2019, 10: ED000142.
[18]	罗慧, 王强, 赵娟, 等. 脊柱手法治疗对慢性非特异性颈痛的影响[J]. 中华物理医学与康复杂志, 2021, 43(5): 422-426.
	LUO H, WANG Q, ZHAO J, et al. Effect of spinal manipulation therapy on chronic non-specific neck pain[J]. Chin J Phys Med Rehabil, 2021, 43(5): 422-426.
[19]	AKI S, ÖZEN A V, ALPTEKIN H K, et al. Short-term effects of chiropractic application and dry needling treatment on chronic mechanical neck pain[J]. Manuelle Medizin, 2020, 58(4-5): 237-245. doi: 10.1007/s00337-020-00695-1
[20]	AKHTER S, KHAN M, ALI S S, et al. Role of manual therapy with exercise regime versus exercise regime alone in the management of non-specific chronic neck pain[J]. Pak J Pharm Sci, 2014, 27(6 Suppl): 2125-2128.
[21]	GALINDEZ-IBARBENGOETXEA X, SETUAIN I, RAMÍREZ-VELEZ R, et al. Short-term effects of manipulative treatment versus a therapeutic home exercise protocol for chronic cervical pain: a randomized clinical trial[J]. J Back Musculoskelet Rehabil, 2018, 31(1): 133-145. doi: 10.3233/BMR-169723
[22]	LEE K W, KIM W H. Effect of thoracic manipulation and deep craniocervical flexor training on pain, mobility, strength, and disability of the neck of patients with chronic nonspecific neck pain: a randomized clinical trial[J]. J Phys Ther Sci, 2016, 28(1): 175-180. doi: 10.1589/jpts.28.175
[23]	MARTEL J, DUGAS C, DUBOIS J D, et al. A randomised controlled trial of preventive spinal manipulation with and without a home exercise program for patients with chronic neck pain[J]. BMC Musculoskelet Disord, 2011, 12: 41-53. doi: 10.1186/1471-2474-12-41
[24]	MURPHY B, TAYLOR H H, MARSHALL P. The effect of spinal manipulation on the efficacy of a rehabilitation protocol for patients with chronic neck pain: a pilot study[J]. J Manipulative Physiol Ther, 2010, 33(3): 168-177. doi: 10.1016/j.jmpt.2010.01.014
[25]	PALMGREN P J, SANDSTRÖM P J, LUNDQVIST F J, et al. Improvement after chiropractic care in cervicocephalic kinesthetic sensibility and subjective pain intensity in patients with nontraumatic chronic neck pain[J]. J Manipulative Physiol Ther, 2006, 29(2): 100-106. doi: 10.1016/j.jmpt.2005.12.002
[26]	VALERA-CALERO A, LLUCH GIRBÉS E, GALLEGO-IZQUIERDO T, et al. Endocrine response after cervical manipulation and mobilization in people with chronic mechanical neck pain: a randomized controlled trial[J]. Eur J Phys Rehabil Med, 2019, 55(6): 792-805.
[27]	GARCÍA-PÉREZ-JUANA D, FERNÁNDEZ-DE-LAS-PEÑAS C, ARIAS-BURÍA J L, et al. Changes in cervicocephalic kinesthetic sensibility, widespread pressure pain sensitivity, and neck pain after cervical thrust manipulation in patient with chronic mechanical neck pain: a randomized clinical trial[J]. J Manipulative Physiol Ther, 2018, 41(7): 551-560. doi: 10.1016/j.jmpt.2018.02.004
[28]	EVANS R, BRONFORT G, SCHULZ C, et al. Supervised exercise with and without spinal manipulation performs similarly and better than home exercise for chronic neck pain: a randomized controlled trial[J]. Spine (Phila Pa 1976), 2012, 37(11): 903-914. doi: 10.1097/BRS.0b013e31823b3bdf
[29]	LAU H M, WING CHIU T T, LAM T H. The effectiveness of thoracic manipulation on patients with chronic mechanical neck pain: a randomized controlled trial[J]. Man Ther, 2011, 16(2): 141-147. doi: 10.1016/j.math.2010.08.003
[30]	MAIERS M, BRONFORT G, EVANS R, et al. Spinal manipulative therapy and exercise for seniors with chronic neck pain[J]. Spine J, 2014, 14(9): 1879-1889. doi: 10.1016/j.spinee.2013.10.035
[31]	MANSILLA-FERRAGUT P, FERNÁNDEZ-DE-LAS PEÑAS C, ALBURQUERQUE-SENDÍN F, et al. Immediate effects of atlanto-occipital joint manipulation on active mouth opening and pressure pain sensitivity in women with mechanical neck pain[J]. J Manipulative Physiol Ther, 2009, 32(2): 101-106. doi: 10.1016/j.jmpt.2008.12.003
[32]	车同同, 杨铁黎, 梁永杰, 等. 下肢低强度加压半蹲起训练对核心区肌群肌肉激活程度和主观疲劳度的影响[J]. 体育科学, 2021, 41(7): 59-66, 78.
	CHE T T, YANG T L, LIANG Y J, et al. Effects of semi-squat BFRT with low intensity on muscle activation and RPE of core muscle group[J]. Chin Sport Sci, 2021, 41(7): 59-66,78.
[33]	杨景慧, 耿喜臣, 卫晓阳, 等. 下肢蹬力专项训练对模拟空战连续载荷下蹬力耐量及肌肉疲劳的影响[J]. 航天医学与医学工程, 2021, 34(6): 415-420.
	YANG J H, GENG X C, WEI X Y, et al. Effects of special training for lower limb pedaling force on pedaling force tolerance and muscle fatigue under continuous load in simulated air combat[J]. Space Med Med Eng, 2021, 34(6): 415-420.
[34]	郭建业, 马明, 孙武东, 等. Mulligan技术治疗慢性踝关节不稳定的疗效观察[J]. 中国康复医学杂志, 2020, 35(12): 1460-1465.
	GUO J Y, MA M, SUN W D, et al. Effect of Mulligan technique on chronic ankle instability[J]. Chin J Rehabil Med, 2020, 35(12): 1460-1465.
[35]	ARJONA RETAMAL J J, FERNÁNDEZ SEIJO A, TORRES CINTAS J D, et al. Effects of instrumental, manipulative and soft tissue approaches for the suboccipital region in subjects with chronic mechanical neck pain. A randomized controlled trial[J]. Int J Environ Res Public Health, 2021, 18(16): 8636. doi: 10.3390/ijerph18168636
[36]	BIALOSKY J E, BENECIUK J M, BISHOP M D, et al. Unraveling the mechanisms of manual therapy: modeling an approach[J]. J Orthop Sports Phys Ther, 2018, 48(1): 8-18. doi: 10.2519/jospt.2018.7476
[37]	MELZACK P, WALL P D. Pain mechanisms: a new theory[J]. Science, 1965, 150(3699): 971-979. doi: 10.1126/science.150.3699.971
[38]	ASPINALL S L, LEBOEUF-YDE C, ETHERINGTON S J, et al. Manipulation-induced hypoalgesia in musculoskeletal pain populations: a systematic critical review and meta-analysis[J]. Chiropr Man Therap, 2019, 27: 7. doi: 10.1186/s12998-018-0226-7
[39]	EMMERT M, SCHUSTER-AMFT C, DE BRUIN E D, et al. Comparison of proprioceptive acuity of the cervical spine in healthy adults and adults with chronic non-specific low back pain: a cross-sectional study[J]. PLoS One, 2019, 14(1): e0209818. doi: 10.1371/journal.pone.0209818
[40]	ERDEM E U, ÜNVER B, AKBAS E, et al. Immediate effects of thoracic manipulation on cervical joint position sense in individuals with mechanical neck pain: a randomized controlled trial[J]. J Back Musculoskelet Rehabil, 2021, 34(5): 735-743. doi: 10.3233/BMR-191798
[41]	COULTER I D, CRAWFORD C, VERNON H, et al. Manipulation and mobilization for treating chronic nonspecific neck pain: a systematic review and meta-analysis for an appropriateness panel[J]. Pain Phys, 2019, 22(2): E55-E70.
[42]	CHOU R, CÔTÉ P, RANDHAWA K, et al. The global spine care initiative: applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities[J]. Eur Spine J, 2018, 27(Suppl 6): 851-860.
[43]	VICTOR A, MATKOVICH G. The effect of spinal manipulation on biceps brachii muscle activity[J]. Chiropr Clin, 2016, 1(1): 14-23.
[44]	GIACALONE A, FEBBI M, MAGNIFICA F, et al. The effect of high velocity low amplitude cervical manipulations on the musculoskeletal system: literature review[J]. Cureus, 2020, 12(4): e7682.
[45]	HAWK C, WHALEN W, FARABAUGH R J, et al. Best practices for chiropractic management of patients with chronic musculoskeletalpain: a clinical practice guideline[J]. J Altern Complement Med, 2020, 26(10): 884-901. doi: 10.1089/acm.2020.0181
[46]	王海棠, 寿涓, 任利民, 等. SF-12量表评价上海市社区老年人生命质量的信效度研究[J]. 中国全科医学, 2019, 22(9): 1057-1061. doi: 10.12114/j.issn.1007-9572.2018.00.329
	WANG H T, SHOU J, REN L M, et al. Reliability and validity of SF-12 for evaluating the quality of life of the elderly in Shanghai community[J]. Chin Gen Prac, 2019, 22(9): 1057-1061. doi: 10.12114/j.issn.1007-9572.2018.00.329
[47]	CASTRO-SÁNCHEZ A M, LARA-PALOMO I C, MATARÁN-PEÑARROCHA G A, et al. Short-term effectiveness of spinal manipulative therapy versus functional technique in patients with chronic nonspecific low back pain: a pragmatic randomized controlled trial[J]. Spine J, 2016, 16(3): 302-312. doi: 10.1016/j.spinee.2015.08.057
[48]	SENNA M K, MACHALY S A. Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome?[J]. Spine (Phila Pa 1976), 2011, 36(18): 1427-1437. doi: 10.1097/BRS.0b013e3181f5dfe0

ICHI β-2编码	治疗部位	动作	方法	ICHI描述符	索引词
MAJ.PA.ZZ	MAJ(头颈部关节)	PA(手法治疗)	ZZ(其他和非特指的方法)	头颈部手法治疗	颞下颌关节手法治疗
MBA.PA.ZZ	MBA(颈椎)			颈椎手法治疗	-
MBG.PA.ZZ	MBG(胸椎)			胸椎手法治疗	-

ICF结构	ICF维度	ICF类目	评价领域	评定工具/指标
身体层面	身体结构	s710 头颈部结构	X线等影像学检查、姿势评估	颈椎序列、椎间隙、节段不稳定程度、CVA等
	身体功能	b2801 身体某部位疼痛	疼痛	VAS、NRS、PPTs
		b710 关节活动功能	关节活动度	颈椎ROM
		b730 肌肉力量功能	肌力	最大肌力测试、表面肌电图时域指标
		b740 肌肉耐力功能	肌耐力	肌耐力测试、表面肌电图频域指标
		d429 改变和保持身体姿势	本体感觉	关节位置觉
个体层面	活动和参与	d5702 保持个体健康	自理	SF-36、SF-12
个体层面	活动和参与	d899 主要生活领域,未特指的	功能障碍程度	NDI

纳入文献	国家	n		年龄/岁		病程/月
纳入文献	国家	试验组	对照组	试验组	对照组	试验组	对照组
罗慧等^[18](2021)	中国	15	15	36.7±4.5	38.5±3.4	10.9±2.1	9.7±2.5
Aki等^[19](2020)	土耳其	20	20	37.30±7.35	37.55±8.20	> 3	> 3
Akhter等^[20](2014)	巴基斯坦	31	31	38.1	39.5	4.12	4.78
Galindez-Ibarbengoetxea等^[21](2018)	西班牙	13	14	32.15±1.87	34.35±1.71	> 3	> 3
Lee等^[22](2016)	韩国	16	15	18~60	18~60	> 3	> 3
Martel等^[23](2011)	加拿大	36	29	36.8±10.5	43.3±10.9	> 3	> 3
Murphy等^[24](2010)	加拿大	8	7	43±8	44±10	108±108	84±60
Palmgren等^[25](2006)	瑞典	18	19	32.7±8.2	31.2±9.0	> 3	> 3
Valera-Calero等^[26](2019)	西班牙	28	组1：28 组2：27	35.64±8.11	组1：37.25±10.54 组2：36.96±8.89	> 3	> 3
García-Pérez-Juana等^[27](2018)	西班牙	组1：18 组2：18	18	组1：35±10 组2：38±7	39±7	组1：39.6±13.2 组2：39.6±10.8	42±13.2
Bronfort等^[15](2004)	加拿大	组1：55 组2：56	49	组1：5±10.5 组2：4.3±11.0	43.6±10.5	组1：78 组2：66	60
Evans等^[28](2012)	美国	86	84	44.1±11.6	48.7±9.6	105.6±97.2	124.8±115.2
Lau等^[29](2011)	中国	57	54	44.17±9.27	43.78±9.25	> 3	> 3
Maiers等^[30](2014)	美国	73	72	71.7±5.2	72.7±5.3	78	60
Mansilla-Ferragut等^[31](2009)	西班牙	18	19	36±7	34±8	≥ 6	≥ 6

Effect of spinal manipulation therapy on chronic nonspecific neck pain: a meta-analysis

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纳入研究	随机序列产生	随机化隐藏	盲法	撤出与退出	总分	质量
罗慧等^[18](2021)	2	1	0	1	4	高
Aki等^[19](2020)	2	1	0	1	4	高
Akhter等^[20](2014)	2	1	0	1	4	高
Galindez-Ibarbengoetxea等^[21](2018)	2	2	1	1	6	高
Lee等^[22](2016)	1	1	1	0	3	低
Martel等^[23](2011)	2	2	0	1	5	高
Murphy等^[24](2010)	1	1	0	1	3	低
Palmgren等^[25](2006)	2	2	0	1	5	高
Valera-Calero等^[26](2019)	2	2	2	1	7	高
García-Pérez-Juana等^[27](2018)	2	2	2	1	7	高
Bronfort等^[15](2004)	2	2	0	1	5	高
Evans等^[28](2012)	2	2	0	1	5	高
Lau等^[29](2011)	2	2	0	1	5	高
Maiers等^[30](2014)	2	2	0	1	5	高
Mansilla-Ferragut等^[31](2009)	2	1	2	1	6	高