针刺治疗腰背肌筋膜炎:系统评价与Meta分析  

Acupuncture for lumbar myofascial pain syndrome:systematic review and Meta-analysis

作　　者：张冉 闻胜月 詹红生[1,2] 林勋[1,2] 张旻[1,2] 庞坚[1,2] 曹月龙[1,2] 陈博[1,2] ZHANG Ran;WEN Sheng-yue;ZHAN Hong-sheng;LIN Xun;ZHANG Min;PANG Jian;CAO Yue-long;CHEN Bo(Shi's Medicine Center of Orthopedics and Traumatology,Shuguang Hospital Affiliated to Shanghai University of TCM,Shanghai 201203,China;Institute of Traumatology and Orthopedics,Shanghai Academy of TCM,Shanghai 201203)

机构地区：[1]上海中医药大学附属曙光医院石氏伤科医学中心,上海201203 [2]上海市中医药研究院骨伤科研究所,上海201203

出　　处：《中国针灸》2023年第11期1324-1332,共9页Chinese Acupuncture & Moxibustion

基　　金：上海市中医非药物疗法示范中心建设项目:ZY(2021-2023)-0204-09;上海市科技创新行动计划医学创新研究专项项目:20MC1920600;上海中医药大学“中医药标准化引领战略”建设项目。

摘　　要：系统评价针刺治疗腰背肌筋膜炎的临床疗效。计算机检索PubMed、Cochrane Library、Web of Science、EMbase、Scopus、中国期刊全文数据库(CNKI)、万方数据知识服务平台(Wanfang)、维普资讯中文期刊服务平台(VIP)、中国生物医学文献服务系统(SinoMed)中针刺治疗腰背肌筋膜炎的随机对照试验中英文文献,检索时间为建库至2022年8月1日。采用Cochrane风险偏倚评估工具对所有纳入的文献进行偏倚风险评价,采用Review Manager 5.3软件对提取的数据进行统计分析。最终纳入12篇随机对照试验文献,共1087例腰背肌筋膜炎患者。Meta分析结果显示:观察组患者疼痛视觉模拟量表(VAS)评分低于口服非甾体抗炎药对照[SMD=-1.67,95%CI(-2.44,-0.90),Z=4.26,P<0.0001]和其他治疗方法对照[低频电刺激、推拿、电磁波照射联合吡罗昔康凝胶,SMD=-1.98,95%CI(-2.48,-1.48),Z=7.74,P<0.00001]。观察组患者疼痛分级指数(PRI)评分低于利多卡因注射对照[MD=-2.17,95%CI(-3.41,-0.93),Z=3.44,P=0.0006]和其他治疗方法对照[低频电刺激、推拿,MD=-5.75,95%CI(-9.97,-1.53),Z=2.67,P=0.008]。观察组患者现有疼痛强度(PPI)评分低于其他治疗方法[低频电刺激、推拿,MD=-1.04,95%CI(-1.55,-0.53),Z=4.01,P<0.0001]。针刺治疗腰背肌筋膜炎较口服非甾体抗炎药、低频电刺激、推拿、电磁波联合吡罗昔康凝胶在降低患者疼痛方面有更好的效果;针刺较利多卡因注射在改善PRI评分方面具有优势;针刺较推拿和低频电刺激在改善PRI、PPI评分方面效果更好。This study systematically reviewed the clinical efficacy of acupuncture for lumbar myofascial pain syndrome.The randomized controlled trials(RCTs)regarding acupuncture for lumbar myofascial pain syndrome were searched in PubMed,Cochrane Library,Web of Science,EMbase,Scopus,China national knowledge infrastructure(CNKI),Wanfang database,VIP database,and China biomedical literature service system(SinoMed)from database inception until August 1st,2022.The Cochrane's risk of bias assessment tool was used to assess the risk of bias in all included studies,and Review Manager 5.3 software was used for statistical analysis of the extracted data.As a result,12 RCTs,involving 1087 patients with lumbar myofascial pain syndrome,were ultimately included.The Meta-analysis results showed that the visual analog scale(VAS)score of pain in the observation group was lower than those in the oral non-steroidal anti-inflammatory medication control[SMD=-1.67,95%CI(-2.44,-0.90),Z=4.26,P<0.0001]and other treatment control[low-frequency electrical stimulation,tuina,electromagnetic wave irradiation combined with piroxicam gel,SMD=-1.98,95%CI(-2.48,-1.48),Z=7.74,P<0.00001].The pain rating index(PRI)score in the observation group was lower than those in the lidocaine injection control[MD=-2.17,95%CI(-3.41,-0.93),Z=3.44,P=0.0006]and other treatment control[low-frequency electrical stimulation,tuina,MD=-5.75,95%CI(-9.97,-1.53),Z=2.67,P=0.008].The present pain intensity(PPI)score in the observation group was lower than that in other treatment control[low-frequency electrical stimulation,tuina,MD=-1.04,95%CI(-1.55,-0.53),Z=4.01,P<0.0001].In conclusion,compared with oral non-steroidal anti-inflammatory medication,low-frequency electrical stimulation,tuina,and electromagnetic wave irradiation combined with piroxicam gel,acupuncture is more effective in reducing pain in patients with lumbar myofascial pain syndrome;acupuncture also exhibites advantage over lidocaine injection in improving PRI score and showed better outcomes over tuina and low-freque

关 键 词：腰背肌筋膜炎 针刺 系统评价 META分析 

分 类 号：R246.2[医药卫生—针灸推拿学]