超声引导下针刀松解治疗肩周炎有效性与安全性的Meta分析  

Meta-analysis of efficacy and safety of ultrasound-guided acupotomy in the treatment of scapulohumeral periarthritis

作　　者：付嘉好 徐铖菡 卢承印 赵安琪 许派 郭文静 沈素红[2] FU Jiahao;XU Chenghan;LU Chengyin;ZHAO Anqi;XU Pai;GUO Wenjing;SHEN Suhong

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]河南省洛阳正骨医院,河南洛阳471002 [3]河南中医药大学,河南郑州450046

出　　处：《中医临床研究》2024年第18期98-104,共7页Clinical Journal Of Chinese Medicine

基　　金：河南省中医药研究专项课题(2018ZY2153)。

摘　　要：目的:系统评价超声引导下针刀松解治疗肩周炎的临床疗效与安全性。方法:计算机检索PubMed、Cochrane Library、中国知网、万方数据库、中国生物医学文献数据库、维普数据库中有关超声引导下针刀松解治疗肩周炎的文献,筛选超声引导下针刀松解治疗肩周炎随机对照试验。参照Cochrane偏倚风险评估工具进行质量评价,采用Revman 5.3软件进行数据分析。结果:经筛选共纳入14篇文献,试验组涉及超声引导下针刀松解治疗、超声引导下针刀松解联合药物注射治疗、超声引导下针刀松解联合液压扩张治疗3种干预措施,对照组均为传统针刀松解治疗。结果显示试验组肩关节视觉模拟疼痛评分在治疗后1周:均数差(MD)=-1.17,95%置信区间(CI)[-1.56,-0.77],P<0.00001、治疗后4周(MD=-1.08,95%CI[-1.36,-0.81],P<0.00001)、治疗后12周(MD=-1.30,95%CI[-1.67,-0.94],P<0.00001),效果均优于对照组;肩关节功能评分(Constant and Murley Scale,CMS)在治疗后1周(MD=11.23,95%CI[6.40,16.06],P<0.00001)、治疗后4周(MD=11.78,95%CI[11.03,12.52],P<0.00001)、治疗后12周(MD=13.66,95%CI[5.81,21.51],P=0.0006)效果均优于对照组;试验组总有效率(94.2%)高于对照组(79.8%),比值比((OR)=4.12,95%CI[2.17,7.82],P<0.0001)、试验组治愈率(41.7%)高于对照组(25.4%)(OR=2.13,95%CI[1.42,3.19],P=0.0002),不良反应发生率与对照组相比差异无统计学意义(OR=0.30,95%CI[0.07,1.35],P=0.12)。结论:超声引导下针刀松解治疗肩周炎患者临床疗效优于传统针刀松解治疗,且在超声引导下联合药物注射或液压扩张疗效更优。超声引导下针刀松解治疗在改善肩周炎患者疼痛、肩关节活动度方面效果显著。Objective:To systematically evaluate the clinical efficacy and safety of ultrasound-guided acupotomy in the treatment of scapulohumeral periarthritis.Methods:PubMed,Cochrane Library,CNKI,Wanfang Database,China Biomedical Literature Database and VIP Database were searched for literatures on ultrasound-guided acupotomy release in the treatment of shoulder periarthritis,and randomized controlled trials of ultrasound-guided acupotomy release in the treatment of shoulder periarthritis were screened.Quality assessment was performed with reference to Cochrane bias risk assessment tool,and data analysis was performed with Revman 5.3 software.Results:A total of 14 literatures were included after screening.The experimental group involved three intervention measures:ultrasound-guided acupotomy release treatment,ultrasound-guided acupotomy release treatment combined with drug injection treatment,ultrasound-guided acupotomy release treatment combined with hydraulic dilation treatment,while the control group received traditional acupotomy release treatment.The results showed that the VAS pain scores of the experimental group were as follows:1 week after treatment(MD=-1.17,95%CI[-1.56,-0.77],P<0.00001),4 weeks after treatment:(MD=-1.08,95%CI[-1.36,-0.81],P<0.00001),and 12 weeks after treatment(MD=-1.30,95%CI[-1.67,-0.94],P<0.00001),the effects were better than those of the control group.Shoulder joint function score(CMS):1 week after treatment(MD=11.23,95%CI[6.40,16.06],P<0.00001),4 weeks after treatment(MD=11.78,95%CI[11.03,12.52],P<0.00001),12 weeks after treatment(MD=13.66,95%CI[5.81,21.51],P=0.0006).The total effective rate of the experimental group(94.2%)was higher than that of the control group(79.8%)(OR=4.12,95%CI[2.17,7.82],P<0.0001),and the cure rate of the experimental group(41.7%)was higher than that of the control group(25.4%)(OR=2.13,95%CI[1.42,3.19].P=0.0002),there was no significant difference in the incidence of adverse reactions compared with that of the control group(OR=0.30,95%CI[0.07,1.35],P=0.12).Conclusion

关 键 词：超声检查 针刀疗法 肩周炎 冻结肩 肩凝症 META分析 

分 类 号：R322.72[医药卫生—人体解剖和组织胚胎学]