穴位注射治疗项背肌筋膜炎临床疗效的Meta分析  

Meta-analysis of Clinical Efficacy of Acupoint Injection for Nape-back Fasciitis

作　　者：周锐 庄礼兴 李克嵩[1] 贺君 ZHOU Rui1, ZHUANG Li-Xing1,2, LI Ke-Song1, HE Jun2(1. Clinical Medical College of Acup-moxibustion ＆ Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510405 Guangdong, China; 2. Rehabilitation Center of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405 Guangdong, Chin)

机构地区：[1]广州中医药大学针灸康复临床医学院,广东广州510405 [2]广州中医药大学第一附属医院康复中心,广东广州510405

出　　处：《广州中医药大学学报》2018年第2期357-363,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(编号:81303069);广州市科技重大专项计划项目(编号:2014Y2-00120)

摘　　要：【目的】采用Meta分析对穴位注射治疗项背肌筋膜炎的临床疗效进行评价,以期为项背肌筋膜炎的临床治疗提供循证依据。【方法】检索Cochrane Library、Pub Med、中国生物医学文献光盘数据库(CBM)、中国期刊全文数据库(CNKI)、万方资源数据库、维普中文期刊数据库等数据库中有关穴位注射治疗项背肌筋膜炎的临床随机对照试验文献,运用Review Manager 5.3软件对纳入文献的研究方法学进行质量评价及偏倚风险评估;同时对主要结局指标有效率及次要结局指标血小板聚集率、血栓烷A(2TXA2)水平等进行Meta分析。【结果】共纳入10项研究,涉及833例样本。Meta分析结果显示:治疗组的有效率高于对照组(OR=7.21,95%CI为[4.16,12.49],合并效应量检验Z=7.04),差异有统计学意义(P<0.01);治疗组降低血小板聚集率作用优于对照组[均数差(MD)为2.50,95%CI为[1.34,3.66],Z=4.23],差异有统计学意义(P<0.01);治疗组降低TXA2水平的作用优于对照组(MD=33.35,95%CI为[22.97,43.72],Z=6.30),差异有统计学意义(P<0.01)。【结论】穴位注射治疗项背肌筋膜炎具有较好的疗效,其降低血液炎性因子的效应亦优于单纯针灸或药物治疗。但鉴于本次研究纳入研究文献较少且质量较低,结论仍需更多大样本多中心及高质量的临床研究加以验证。Objective To assess the clinical curative effect of acupoint injection for the treatment of nape-back fasciitis by Meta-analysis, thus to provide evidence for the treatment of nape-back fasciitis. Methods A retrieval of literatures concerning treatment of nape-back fasciitis with acupoint injection was carried out in the databases of Cochrane Library,Pub Med, CMB, CNKI, Wanfang and VIP. Review Manager 5.3 software was used for the evaluation of methodological quality and bias risk of the included randomized controlled trials（RCT）which met the enrolling requirements. At the same time, Meta-analysis was carried out for the main outcome measure of effective rate and the secondary outcome measures of platelet aggregation rate and thromboxan A2（TXA2） level. Results A total of 10 RCT involving 833 cases were included. The results showed that the treatment group had higher effective rate than the control group（OR = 7.21, 95% CI [ 4.16, 12.49], in the combined effect test Z = 7.04）,and the difference was significant（P〈0.01）;the treatment group had better effect on decreasing the platelet aggregation rate {mean difference（MD）being 2.50,95% CI [1.34,3.66],Z =4.23} and on reducing the level of TXA2（MD = 33.35,95%CI [22.97,43.72],Z = 6.30） than the control group, the difference being significant（P〈0.01）. Conclusion Acupoint injection exerts certain therapeutic effect for the treatment of nape-back fasciitis,and its effect on reducing blood inflammatory factors is better than that of acupuncture or drug therapy alone. However,due to the small quantity and low quality of the included studies,more large-sample,multi-center and high-quality clinical studies are needed to validate the results.

关 键 词：项背肌筋膜炎 穴位注射疗法 血小板聚集 血栓烷A2 META分析 

分 类 号：R245.95[医药卫生—针灸推拿学]