针刀治疗屈指肌腱狭窄性腱鞘炎系统评价  

System Review of Acupotomy Treatment for Stenosing Tenovaginitis of Flexor Digitorum

作　　者：张继伟[1] 江苏闽 吴海波[1] 詹红生[1,2] 陈东煜[1,2] 

机构地区：[1]上海中医药大学附属曙光医院石氏伤科医学中心,上海201203 [2]上海市中医药研究院骨伤科研究所,上海201203

出　　处：《中国中医药信息杂志》2016年第7期46-50,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家重点学科-中医骨伤科学(100508);上海市科学技术委员会科研计划项目(13401903500);上海市中医药事业发展三年行动计划(ZYSNXD-CC-ZDYJ047);上海市中医药领军人才建设项目(2012-63-15)

摘　　要：目的 系统评价针刀治疗屈指肌腱狭窄性腱鞘炎临床疗效.方法 计算机检索中国知识资源总库（CNKI）、中文科技期刊数据库（VIP）、中国学术期刊数据库（万方数据）、中国生物医学文献数据库（CBM）、Embase、PubMed、Cochrane Library 中针刀与局部封闭注射对比治疗屈指肌腱狭窄性腱鞘炎临床随机对照试验相关文献;2 名研究者根据Cochrane 系统评价手册5.1.0 独立筛选文献、提取资料、交叉核对及质量评价后,采用RevMan5.3 软件进行Meta 分析,合并比值比（OR）评价针刀治疗屈指肌腱狭窄性腱鞘炎的总有效率、治愈率和好转率.结果 共纳入10 篇文献,共计受试者1426 例.Meta 分析结果显示：针刀组治愈率优于封闭组[OR=13.11（95%CI：8.23～20.89）,Z=10.83（P〈0.000 01）],漏斗图Begg＇s 检验P=0.858,Egger＇s检验P=0.579;封闭组好转率略优于针刀组[OR=0.14（95%CI：0.10～0.19）,Z=11.60（P〈0.000 01）],漏斗图Begg＇s 检验P=1.000,Egger＇s 检验P=0.926;针刀组总有效率优于封闭组[OR=18.26（95%CI：9.95～33.50）,Z=9.38（P〈0.000 01）],漏斗图Begg＇s 检验P=0.592,Egger＇s 检验P=0.936.结论 针刀治疗屈指肌腱狭窄性腱鞘炎临床疗效确切,且总体优于局部封闭治疗.但纳入研究质量普遍较低,尚需更多大样本、多中心、高质量的临床随机对照试验进一步验证.Objective To systematically evaluate the efficacy of acupotomy treatment for the stenosing tenovaginitis of flexor digitorum.Methods Articles about RCTs of acupotomy treatment and local blocking for the treatment of stenosing tenovaginitis of flexor digitorum were retrieved from CBM, CNKI, VIP, Wanfang database, PubMed, Embase, and Cochrane library. And then according to the requirement of Cochrane Handbook for Systemetic Reviews 5.1.0, two reviewers independently chose tests, extracted data, had a cross check, accessed methodological qualities and finally used RevMan 5.3 software for Meta analysis. The total effective rate, cure rate and improvement rate of acupotomy treatment and local blocking in treating stenosing tenovaginitis of flexor digitorum were assessed by using odds ratio (OR).Results Totally 10 articles involving 1426 cases were included. The cure rate in acupotomy treatment group was higher than that of local blocking group [OR=13.11 (95% CI: 8.23–20.89),Z=10.83 (P<0.000 01)], funnel plot Begg’s testP=0.858, Egger’s testP=0.579; the improvement rate of local blocking rate was higher than that of acupotomy treatment group [OR=0.14 (95% CI: 0.10–0.19),Z=11.60 (P<0.000 01)], funnel plot Begg’s test P=1.000, Egger’s testP=0.926; the total effective rate of acupotomy treatment group was higher than that of local blocking group [OR=18.26 (95% CI: 9.95–33.50),Z=9.38 (P<0.000 01)], funnel plot Begg’s testP=0.592, Egger’s testP=0.936.Conclusion Acupotomy treatment for stenosing tenovaginitis of flexor digitorum is superior to local blocking injection. However, the quality of the RCTs is low, so more large-sample, multi-center, and high-quality clinical RCTs are required for further verification.

关 键 词：针刀 局部封闭注射 屈指肌腱狭窄性腱鞘炎 系统评价 META分析 

分 类 号：R274.96[医药卫生—中西医结合] R2-05[医药卫生—中医骨伤科学]