体外冲击波治疗冈上肌肌腱炎临床疗效的meta分析  

Extracorporeal shock wave therapy for supraspinatus tendinitis:A meta-analysis

作　　者：赵颖岚 周市幼[2] ZHAO Yinglan;ZHOU Shiyou(Hubei University of Chinese Medicine,Wuhan,Hubei 430061,China;Department of Massage,Wuhan Hospital of Traditional Chinese Medicine,Wuhan,Hubei 430014,China)

机构地区：[1]湖北中医药大学,湖北武汉430061 [2]武汉市中医医院推拿科,湖北武汉430014

出　　处：《现代医药卫生》2023年第17期2960-2966,共7页Journal of Modern Medicine & Health

摘　　要：目的系统评价体外冲击波疗法治疗冈上肌肌腱炎的临床疗效。方法计算机检索知网、维普、万方、CBM、PubMed、Web of Science数据库,搜集有关体外冲击波疗法治疗冈上肌肌腱炎的随机对照试验,检索时限为建库至2022年11月15日。由2名筛选员挑选合乎标准的文献,运用RevMan5.4软件对纳入文献进行偏倚风险评估及meta分析,再用Stata17.0软件进一步对纳入文献进行敏感性分析、meta回归分析及发表偏倚分析。结果共纳入15篇文献含16个随机对照试验,共803例患者,其中观察组404例,对照组399例。Meta分析结果显示,观察组疼痛视觉模拟评分[加权均数差(WMD)=-1.52,95%可信区间(95%CI)-2.13~-0.19,P<0.00001]、Constant-Murley评分(WMD=9.81,95%CI 6.47~13.16,P<0.00001)、钙化灶吸收有效率[相对危险度(RR)=1.37,95%CI 1.19~1.58,P<0.0001]方面均优于对照组。疼痛视觉模拟评分及Constant-Murley评分所纳入文献异质性高,该结论经过敏感性分析后较为稳健。Meta回归分析也未找到其他异质性来源。发表偏倚结果显示,Constant-Murley评分存在潜在的发表偏倚风险(Begg检验:t=3.18,P=0.008)。结论体外冲击波疗法对于缓解冈上肌肌腱炎疼痛、提高钙化灶吸收有效率均有积极的作用,但该研究中文献质量不一,且Constant-Murley评分存在发表偏倚风险的可能。Objective To systematically review the efficacy of extracorporeal shock wave therapy(ES-WT)in the treatment of supraspinatus tendinitis to provide evidence for clinical practice.Methods Random-ized controlled trials for ESWT of supraspinatus tendinitis published from the inception of databases to No-vember 15,2022 were searched from China National Knowledge Internet,VIP,Wanfang,Chinese BioMedical Literature Database,PubMed and Web of Science Database.After fetching data from the included articles by two reviewers,meta analysis and quality evaluation were conducted with RevMan5.4 software,and then the included literatures were further subjected to sensitivity analysis,meta-regression analysis and publication bias with Stata 17.0 software.Results A total of 15 pieces of eligible literature and 803 patients,were included in this study,including 404 patients in the experimental group and 399 patients in the control group.Meta-analy-sis showed that the experimental group with ESWT had better improvement in visual analogue scale score of pain(WMD=-1.52,95%CI-2.13--0.19,P<0.00001),Constant-Murley score(WMD=9.81,95%CI 6.47-13.16,P<0.00001)and disappearance of calcification(RR=1.37,95%CI 1.19-1.58,P<0.0001)than the control group.The literature which included visual analogue scale score and Constant-Murley score had high heterogeneity,and the sensitivity analysis showed that this result was stable.Meta analysis found nothing about the sources of heterogeneity.The result of publication bias showed that there was a publication bias in Constant-Murley score(Begg test:t=3.18,P<0.008).Conclusion ESWT is effective in alleviating pain and improving the absorption efficiency of calcification focus.However,the quality of the literature in this study is different,and the Constant-Murley score may be biased.

关 键 词：冈上肌肌腱炎 体外冲击波 临床疗效 META分析 

分 类 号：R68[医药卫生—骨科学]