针刀结合局部药物注射治疗肩关节周围炎的Meta分析  

Clinical efficacy of needle knife combined with local drug injection for periarthritis of shoulder:a Meta analysis

作　　者：邢光艳 李伟[1] 赵子义[2] XING Guangyan;LI Wei;ZHAO Ziyi(Beijing University of Chinese Medicine,Beijing 100029;Department of Orthopedics,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东直门医院骨科,北京100700

出　　处：《河北中医》2022年第3期495-500,共6页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的采用Meta分析系统评价针刀结合局部药物注射治疗肩关节周围炎(以下简称肩周炎)的临床疗效。方法通过中国知识基础设施工程(CNKI)、万方数据知识服务平台(Wangfang)、维普资讯有限公司(VIP)、美国医学在线(PubMed)及国际循证医学图书馆(The Cochrane Library)数据库,检索从建库至2021年2月以针刀结合局部药物注射为主治疗肩周炎的随机对照试验。按照Cochrane系统评价手册对筛选后纳入的文献进行质量评价,并使用RevMan 5.3统计软件,以总有效率、疼痛视觉模拟评分(VAS)及Constant-Murley肩关节功能评分(CMS)作为结局指标对纳入文献进行分析。结果通过检索共纳入13篇文献,均为随机对照研究的中文文献,共包含1528例患者,其中试验组778例,对照组750例。Meta分析结果显示试验组与对照组在总有效率[OR=7.34,95%CI(4.33,12.43),P<0.00001]、疼痛VAS[MD=-1.30,95%CI(-1.73,-0.87),P<0.00001]、CMS评分[MD=13.33,95%CI(10.15,16.51),P<0.00001]方面比较差异均有统计学意义(P<0.05)。结论针刀结合局部药物注射疗法治疗肩周炎疗效确切,对于改善肩关节活动度、减轻疼痛有着显著效果,但受限于纳入研究的文献数量和质量,以上结论尚需在临床试验中进一步验证。Objective To evaluate the clinical efficacy of needle knife combined with local drug injection for periarthritis of shoulder(PAS)based on Meta analysis.Methods The randomized controlled trials(RCTs)regarding needle knife combined with local drug injection for PAS were searched form Databases of China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP,PubMed,and the Cochrane Library from inception to February 2021.The quality of included literatures was evaluated using the Cochrane System Review Manual.The overall effective rate,Visual Analogue Scale(VAS)and Constant-Murley score(CMS)was regarded as outcome indicators,Review Manager 5.3(RevMan 5.3)was used to analyze the included literatures.Results A total of 13 Chinese literatures of RCTs were included,comprising of 1528 patients,of which 778 were in the experimental group and 750 were in the control group.Meta-analysis showed that the difference was statistically significant in the overall effective rate[OR=7.34,95%CI(4.33,12.43),P<0.00001],VAS[MD=-1.30,95%CI(-1.73,-0.87),P<0.00001]and CMS scores[MD=13.33,95%CI(10.15,16.51),P<0.00001]between the experimental group and the control group.Conclusion For patients with PAS,needle knife combined with local drug injection has a definite curative effect,which can significantly improve the shoulder mobility and relieve pain.However,it is limited by the quantity and quality of the literature included in the study,the above conclusion needs to be further verified in clinical trials.

关 键 词：肩周炎 肩凝症 小刀针 注射 关节内 META分析 

分 类 号：R684.73[医药卫生—骨科学]