体外冲击波疗法治疗肱骨外上髁炎中、长期疗效的荟萃分析  

A Meta-Analysis of Medium-and Long-Term Effects of Extracorporeal Shock Wave Therapy on Epicondylitis

作　　者：王乐政 杨坚[2] 刘向云[1] 刘珊珊 WANG Le-zheng;YANG Jian;LIU Xiang-yun;LIU Shan-shan(Shanghai University of Sport,Shanghai 200438;Shanghai Xuhui District Central Hospital,Shanghai 200031)

机构地区：[1]上海体育学院,上海200438 [2]上海市徐汇区中心医院,上海200031

出　　处：《按摩与康复医学》2020年第6期23-27,共5页Chinese Manipulation and Rehabilitation Medicine

摘　　要：目的:荟萃分析体外冲击波对肱骨外上髁炎的中、远期疗效和安全性。方法:计算机检索PubMed、Medline、EMBASE、Cochrane图书馆和CNKI、VIP、CBM、万方数据库从建库至2019年4月,体外冲击波治疗肱骨外上髁炎的临床随机对照试验,使用RevMan5.3软件进行荟萃分析。结果:共纳入来自9项RCT研究,共计481例患者。结果显示,在治疗结束后8~12周内,体外冲击波治疗组更有效地缓解疼痛[WMD=-29.05,95%CI(-36.24,-18.87),P=0.01],而在治疗结束后第4周时[WMD=-2.11,95%CI(-4.91,0.69),P=0.14]、第24周时[WMD=-8.04,95%CI(-25.32,9.23),P=0.36]及48~96周[WMD=-12.1,95%CI(-34.43,10.24),P=0.29]疼痛缓解程度,组间差异无统计学意义;治疗结束后4~6周握力(单位:kg)评分差异无统计学意义[WMD=-0.54,95%CI(-6.75,5.68),P=0.87]。结论:现有的临床证据表明,作为一种无创性治疗手段,体外冲击波可显著改善患者的疼痛症状,并与其他疗法相比,具有中、长期镇痛的疗效优势,且临床应用安全有效。Objective:To Meta-analyze the medium-and long-term efficacy and safety of extracorporeal shock wave(ESWT)in the treatment of external humeral epicondylitis.Methods:Computer retrieval PubMed,Medline,EMBASE,the Cochrane library and CNKI,VIP,CBM,database from the database of ten thousand to 2019 in April,on the outside of extracorporeal shock wave treatment of humerus condyle clinical randomized controlled trials,and use RevMan 5.3 Software for Meta-analysis.Results:A total of 481 patients from 9 RCT studies were enrolled.The results showed that the ESWT group was more effective in alleviating pain[WMD=-29.05,95%CI(-36.24,-18.87),P=0.01]within 8-12 weeks after the end of treatment,while at 4 weeks after the end of treatment[WMD=-2.11,95%CI(-4.91,0.69),P=0.14],24 weeks[WMD=-8.04,95%CI(-25.32,9.23),P=0.36]and 48~96 weeks[WMD=-12.1,95%CI(34.43,10.24),P=0.29]the degree of pain relief,no statistical difference between the two groups.4-6 weeks after treatment,grip there was no statistically significant difference(unit:kg)score[WMD=0.54,95%CI(6.75,5.68),P=0.87].Conclusions:Existing clinical evidence shows that as a non-invasive treatment,extracorporeal shock wave can significantly improve the pain symptoms of patients,and has medium and long-term analgesic effect advantages compared with other therapies,and clinical application is safe and effective.

关 键 词：肱骨外上髁炎/网球肘 体外冲击波疗法 Meta分析 VAS评分 

分 类 号：R681.7[医药卫生—骨科学]