刮痧联合拔罐治疗肩周炎效果的Meta分析  

Effect of scraping combined with cupping therapy on shoulder periarthritis:a Meta-analysis

作　　者：蒋晓峰 余进 郑爽[1] 李颖超 王淑荣 JIANG Xiaofeng;YU Jin;ZHENG Shuang;LI Yingchao;WANG Shurong(Heilongjiang University of Chinese Medicine,Heilongjiang 150040 China)

机构地区：[1]黑龙江中医药大学,黑龙江150040 [2]黑龙江中医药大学附属第二医院

出　　处：《循证护理》2024年第2期225-231,共7页Chinese Evidence-Based Nursing

摘　　要：目的:系统评价刮痧联合拔罐治疗肩周炎的效果。方法:计算机检索PubMed、EMbase、Web of Science、the Cochrane Library、中国知网(CNKI)、万方数据库(WanFang Database)、维普数据库(VIP)、中国生物医学文献数据库(CBM)等关于刮痧联合拔罐治疗肩周炎的随机对照研究,检索时限为各数据库建库至2023年6月13日。由2名研究人员独立筛选文献、提取资料,并根据Cochrane干预措施系统评价手册中的偏倚风险评估工具对纳入文献进行评估,采用RevMan 5.4.1软件进行数据分析。结果:共纳入10项随机对照研究,涉及1042例病人。Meta分析结果显示,刮痧联合拔罐治疗肩周炎的临床有效率高于单纯拔罐[RR=1.18,95%CI(1.13,1.24),Z=6.89,P<0.00001],现有疼痛强度(PPI)评分[MD=-0.88,95%CI(-1.00,-0.76),Z=13.91,P<0.00001]、视觉模拟疼痛(VAS)评分[MD=-1.40,95%CI(-1.47,-1.34),Z=40.66,P<0.00001]、疼痛指数(PRI)评分[MD=-7.29,95%CI(-8.02,-6.55),Z=19.35,P<0.00001]、肩关节功能(Melle)评分[MD=-2.67,95%CI(-2.93,-2.41),Z=20.06,P<0.00001]低于单纯拔罐,Constant-Murley肩关节评分系统中肌力[MD=2.34,95%CI(1.44,3.25),Z=5.08,P<0.00001]、日常活动[MD=2.14,95%CI(1.46,2.82),Z=6.17,P<0.00001]、关节活动度[MD=4.49,95%CI(3.05,5.93),Z=6.12,P<0.00001]高于单纯拔罐,而疼痛评分比较差异无统计学意义(P>0.05)。结论:现有证据表明,刮痧联合拔罐对肩周炎的治疗有效。但因纳入的文献样本量有限且质量不高,建议临床上开展高质量、大样本的随机对照研究,为刮痧联合拔罐治疗肩周炎病人提供有力的循证医学证据。Objective:To systematically evaluate the therapeutic effect of scraping combined with cupping therapy on scapulohumeral periarthritis.Methods:Randomized controlled studies of scraping combined with cupping therapy on shoulder periarthritis were collected from PubMed,EMbase,Web of Science,the Cochrane Library,CNKI,WanFang Database,VIP,and CBM.The search deadline was from the establishment of each database until June 13,2023.Two researchers independently screened the literature,extracted data,and evaluated the included literature using the bias risk assessment tool in the Cochrane Intervention System Evaluation Manual.RevMan 5.4.1 software was used for data analysis.Results:A total of 10 randomized controlled studies were included,involving 1042 patients.The Meta-analysis results showed that the clinical effective rate(RR=1.18,95%CI 1.13-1.24,Z=6.89,P<0.00001)of the combination of scraping and cupping treatment for shoulder periarthritis was higher than that of the cupping group;The PPI score(MD=-0.88,95%CI-1.00--0.76,Z=13.91,P<0.00001),VAS score(MD=-1.40,95%CI-1.47--1.34,Z=40.66,P<0.00001),PRI score(MD=-7.29,95%CI-8.02--6.55,Z=19.35,P<0.00001),and Melle score(MD=-2.67,95%CI-2.93--2.41,Z=20.06,P<0.00001)of the scraping combined cupping group were lower than those of the cupping group;The Constant-Murley score(muscle strength)(MD=2.34,95%CI 1.44-3.25,Z=5.08,P<0.00001),Constant-Murley score(daily activity)(MD=2.14,95%CI 1.46-2.82,Z=6.17,P<0.00001),and Constant-Murley score(joint range of motion)(MD=4.49,95%CI 3.05-5.93,Z=6.12,P<0.00001)in the combination of scraping and cupping group were higher than those in the cupping group.There was no significant difference in Constant-Murley score(pain)between the two groups(P>0.05).Conclusion:The existing evidence shows that scraping combined with cupping therapy is effective in the treatment of periarthritis of shoulder.However,due to the limited sample size and low quality of the included literature,it is recommended to carry out high-quality randomized controlled studies wi

关 键 词：刮痧 拔罐 肩周炎 META分析 循证护理 

分 类 号：R473.6[医药卫生—护理学]