肩关节松动术治疗肩关节周围炎Mate分析  

Meta-analysis of Clinical Efficacy of Arthodesis in Treating Scapulohumeral Periarthritis

作　　者：田鹏 朱朝霞 张黄鑫 范宏元 TIAN Peng;ZHU Zhaoxia;ZHANG Huangxin;FAN Hongyuan(Guizhou University of Traditional Chinese Medicine, Guizhou Guiyang 550002, China;The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guizhou Guiyang 550025, China)

机构地区：[1]贵州中医药大学,贵州贵阳550002 [2]贵州中医药大学一附院贵州省中医院,贵州贵阳550025

出　　处：《中医药临床杂志》2019年第7期1302-1307,共6页Clinical Journal of Traditional Chinese Medicine

摘　　要：目的:系统评价肩关节松动术医治肩关节周围炎的治疗效果,了解其有效及安全性;方法:通过计算机查阅建库至2018年6月的肩关节松动术单独或联合其他疗法治疗肩周炎的临床随机对照试验(RCT),数据库包括:中国知网数据库(CNKI)、PubMed全文数据库、EMbase、The Cochrane Library、中国生物医学文献数据库(CBM)、维普(VIP)及万方等数据库,从筛选、纳入文献到质量评价和评估偏倚风险整个过程由2位工作员独立完成,并纳入RevMan5.3软件行数据分析;结果:共纳入11篇RCT文献,总病例数:共906例,其中试验组466例,对照组440例,有8篇显示关节松动术总有效率(MD=1.22,95%CI=[1.07,1.40],P=0.004)及痊愈率(MD=1.34,95%CI=[1.02,1.76],P=0.004)更高,4篇提及VAS评分(MD=-1.09,95%CI=[-1.65,-0.54],P=0.0001)试验组在减轻肩周炎疼痛程度上优于对照组,2篇提及ROM评分(RR=2.06,95%CI=[0.96,3.16],P=0.0002)试验组优于对照组;结论:对于肩关节周围炎患者,关节松动术在肩关节功能改善及疼痛减轻方面的临床疗效确切,且安全性较高;但本次Meta分析存在研究文献jadad评分总体偏低,样本量尚少、疗效标准及结局指标不统一等问题,因此,需要更多高质量的随机对照双盲试验来进一步验证肩关节松动术医治肩关节周围炎的疗效。Objective:To systematically evaluate the clinical efficacy of Arthrodesis in the treatment of Scapulohumeral Periarthritis,and to understand its effectiveness and safety.Methods:Databases such as CNKI,Pub Med,EMbase,The Cochrane Library,CBM,VIP and WANFANG DATA were retrieved by computer to find randomized controlled trials(RCT)of treating Scapulohumeral Periarthritis with Arthrodesis alone or combined with others(from the establishment of the databases to June 2018).Two researchers independently screening,inclusion and quality evaluation of the literature and assessed the risk of bias,and analyzed the data using software Rev Man 5.3.Results:A total of11 RCT articles with 906 sample cases were included,including 466 experimental groups and 440 control groups.The results of Meta-analysis showed that the total efficiency(MD = 1.22,95%CI=[1.07,1.40],P= 0.004)and recovery rate(MD = 1.34,95%CI =[1.02,1.76],P = 0.004)of Arthodesis was higher in 8 articles,4 references to VAS score(MD =-1.09,95%CI =[-1.65,-0.54],P =0.0001)the experimental group was superior to the control group in reducing the pain of Scapulohumeral Periarthritis,2 articles refer to ROM score(RR=2.06,95%CI=[0.96,3.16],P=0.0002)that the experimental group was superior to the control group.Conclusion:For patients with Scapulohumeral Periarthritis,Arthrodesis is effective and safe in improving shoulder joint function and relieving pain.More higher-quality,Large sample,higher jadad score randomized controlled double-blind trials will be needed to verify the curative effect of Arthrodesis in treating Scapulohumeral Periarthritis.

关 键 词：肩关节松动术 肩关节周围炎 临床疗效 Mate分析 

分 类 号：R274.31[医药卫生—中医骨伤科学]