体外冲击波疗法治疗骨髓水肿疗效的Meta分析  

Meta-analysis of extracorporeal shock wave therapy in the treatment of bone marrow edema

作　　者：胡浩 刘瀚文 余坤 刘寅申 韩鹏坤 刘佳强 黎茂如 谭美云 Hu Hao;Liu Hanwen;Yu Kun;Liu Yinshen;Han Pengkun;Liu Jiaqiang;Li Maoru;Tan Meiyun(Department of Bone and Joint Surgery,Affiliated Hospital of Southwest Medical University,Luzhou Sichuan,646000,China)

机构地区：[1]西南医科大学附属医院骨与关节外科,四川泸州646000

出　　处：《生物骨科材料与临床研究》2025年第1期49-57,共9页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的采用Meta分析法比较体外冲击波疗法治疗骨髓水肿的疗效。方法使用计算机检索PubMed、EMbase、Web of Science、Cochrane Library、中国知网、万方、维普。检索时间为建库至2024年1月,检索词:“Extracorporeal shockwave therapy、Shock wave therapy、Bone marrow edema syndrome、冲击波治疗、体外冲击波疗法、骨髓水肿、骨髓水肿综合征”,检索国内外所有关于对比研究体外冲击波疗法治疗骨髓水肿综合征的文献。由2名研究员根据纳入和排除标准分别独立筛选文献,提取数据。使用Review Manager 5.4统计分析软件进行结局指标Meta分析。结果①共计8项研究符合纳入标准,其中包括4篇随机对照试验,2篇回顾性队列研究,2篇前瞻性队列研究,均纳入此Meta分析,共计522例患者,其中冲击波治疗组为296例,对照组为226例。其中包括4篇冲击波治疗膝关节骨髓水肿研究,2篇髋关节骨髓水肿研究,1篇踝关节骨髓水肿研究,以及1篇耻骨骨髓水肿的研究;②Meta分析结果显示,冲击波组在短期(1个月)治疗骨髓水肿的疼痛VAS评分明显低于对照组[WMD=-1.55,95%CI(-1.84,-1.26),P<0.00001];冲击波组在中期(3~6个月)治疗骨髓水肿的疼痛VAS评分明显低于对照组[WMD=-1.46,95%CI(-2.93,-0.00),P=0.05];冲击波组在远期(12个月及以上)治疗骨髓水肿的疼痛VAS评分是明显低于对照组的[WMD=-1.53,95%CI(-2.79,-0.26),P=0.02]。冲击波组在短期(1个月)治疗骨髓水肿的关节功能评分与对照组之间无明显差异[WMD=1.14,95%CI(-1.25,3.53),P=0.35];冲击波治疗中期膝关节关节功能评分差异有统计学意义[WMD=-1.36,95%CI(-1.71,-1.01),P<0.00001];冲击波组在远期(12个月及以上)治疗骨髓水肿的关节功能评分与对照组之间无明显差异[WMD=0.47,95%CI(-1.77,2.72),P=0.68]。冲击波治疗MRI上骨髓水肿面积与对照组之间无明显差异[WMD=0.43,95%CI(-3.73,4.59),P=0.84]。结论体外冲击波疗法在治疗骨髓水肿方面可Objective To compare the efficacy of extracorporeal shock wave therapy in the treatment of bone marrow edema.Methods A computerized search of PubMed,EMbase,Web of Science,Cochrane Library,China Knowledge Network,Wanfang,and VIP was used.The search period was from the establishment of the library to January 2024,and the search terms were:"Extracorporeal shockwave therapy,Shock wave therapy,Bone marrow edema syndrome''to search all domestic and international literature on comparative studies of extracorporeal shockwave therapy for bone marrow edema syndrome.Two researchers independently screened the literature for inclusion and exclusion criteria and extracted the data.Meta-analysis of outcome indicators was performed using Review Manager 5.4 statistical analysis software.Results①A total of 8 studies met the inclusion criteria,including 4 randomized controlled trials,2 retrospective cohort studies,and 2 prospective cohort studies,which were included in this Meta-analysis,with a total of 522 patients,of which 296 cases were in the shockwave treatment group and 226 cases in the control group.These included 4 studies on shockwave treatment of knee bone marrow edema,2 studies on hip bone marrow edema,1 study on ankle bone marrow edema,and 1 study on pubic bone marrow edema;②Meta-analysis showed that the pain VAS scores of the shockwave group in the shortterm treatment of bone marrow edema were significantly lower than those of the control group[WMD=-1.55,95%CI(-1.84,-1.26),P<0.00001];pain VAS scores in the shockwave group were significantly lower than those in the control group in the intermediate term(3-6 months)of treatment for myeloedema[WMD=-1.46,95%CI(-2.93,-0.00),P=0.05];and pain VAS scores in the shockwave group in the long term(12 months and beyond)of treatment for myeloedema were significantly lower than those in the control group[WMD=-1.53,95%CI(-2.79,-0.26),P=0.02].There was no significant difference between the joint function scores of the shockwave group and the control group in the short-term(1 month)

关 键 词：体外冲击波疗法 骨髓水肿 骨髓水肿综合征 

分 类 号：R318[医药卫生—生物医学工程]