小针刀配合手法治疗肩关节周围炎系统评价  

Systematic Review on Curative Effect of Small-needle-knife Therapy Combined with Manipulation on Frozen Shoulder

作　　者：杨伟毅 韩燕鸿[2] 刘军 潘建科 罗明辉 曹学伟 YANG Wei-yi;HAN Yan-hong;LIU Jun;PAN Jian-ke;LUO Ming-hui;CAO Xue-wei(Department of Orthopedics, Second Hospital Affiliated to Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of TCM), Guangzhou 510120, China;Second School of Clinic Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China)

机构地区：[1]广州中医药大学第二附属医院(广东省中医院)骨科,广东广州510120 [2]广州中医药大学第二临床医学院,广东广州510405

出　　处：《中国中医药信息杂志》2018年第1期94-98,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家自然科学基金(81473698;81273781);教育部高等学校博士点科研基金(20124425110004);国家中医药管理局中医药标准化项目(SATCM-2015-BZ115;SATCM-2015-BZ173);广东省财政厅项目(E44921);广东省中医药局科研项目(20164020);广东省中医院中医药科学技术研究专项(YK2013B2N19;YN2015MS15)

摘　　要：目的系统评价小针刀配合手法治疗肩关节周围炎(以下简称"肩周炎")的临床疗效。方法计算机检索中国知识资源总库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊数据库(重庆维普)、中国学术期刊数据库(万方数据)、Pub Med、Embase、Cochrane Library收录的小针刀配合手法治疗肩周炎临床随机对照试验相关文献。检索范围均为建库至2017年2月。2名研究者独立筛选文献、提取资料,按照Cochrane系统评价手册5.1.0对纳入文献进行质量评价,采用Rev Man5.3软件进行Meta分析。结果共纳入12篇文献,共计受试者1118例。Meta分析结果显示:与单纯手法治疗或手法配合针灸治疗比较,小针刀配合手法治疗肩周炎可明显提高临床总有效率[OR=5.07,95%CI(3.07,8.37),P<0.000 01]和痊愈率[OR=2.89,95%CI(2.21,3.78),P<0.000 01],改善运动功能评分[MD=63.98,95%CI(38.61,89.35),P<0.000 01],差异有统计学意义。结论小针刀配合手法治疗肩周炎疗效确切。但纳入文献质量普遍偏低,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 small-needle-knife therapy combined with manipulation in treating frozen shoulder.Methods Articles about small-needle-knife therapy combined with manipulation treating frozen shoulder clinical randomized controlled trials in CNKI,CBM,VIP,Wanfang Data,Embase,Cochrane Library and Pubmed database were searched.Retrieval time was from the establisment of the database to February2017.Two researchers screened literature,extract materials independently.The quality of the included studies was evaluated according to the Cochrane System Evaluation Manual5.1.0.Meta-analysis was performed by using RevMan5.3software.Results12articles were included in a systematic review,a total of1118cases of patients.Meta-analysis showed that,compared with small-needle-knife therapy alone,small-needle-knife therapy combined with manipulation in the treatment of frozen shoulder could significantly improve the total effective rate[OR=5.07,95%CI(3.07,8.37),P<0.00001]and cure rate[OR=2.89,95%CI(2.21,3.78),P<0.00001],enhance motor function score[MD=63.98,95%CI(38.61,89.35),P<0.00001],with statistical significance.Conclusion Smallneedle-knife therapy combined with manipulation had definite efficacy in the treatment of frozen shoulder.However,the quality of included research is relatively low,so large-sample,multi-center and high-quality randomized controlled trials are required for verification.

关 键 词：小针刀 手法 肩关节周围炎 系统评价 

分 类 号：R2-05[医药卫生—中医学] R245