小针刀治疗屈指肌腱狭窄性腱鞘炎的系统评价

Acupotomyfor Trigger Finger: A Systematic Review

目的:评价小针刀治疗屈指肌腱狭窄性腱鞘炎的有效性和安全性。方法:检索中国期刊全文数据库(中国知网CNKI)、中国生物医学文献数据库(CBM)、维普中文科技期刊数据库(VIP)、万方中华医学会期刊数据库(Wanfang Data)、Pub Med数据库、Cochrane Library数据库以及Embase数据库,筛选小针刀治疗屈指肌腱狭窄性腱鞘炎的临床随机对照试验(RCT),采用Review Manager(Rev Man)5.3软件进行Meta分析。结果:共纳入16个研究,共计1857例患者。Meta分析结果显示,小针刀治疗的有效率(RR=1.28,95%CI[1.15,1.42],P<0.00001)、复发率(RR=0.14,95%CI[0.08,0.25],P<0.00001)、VAS评分(WMD=-2.85,95%CI[-5.38,-0.31],P=0.003)均优于局部封闭治疗,而两组的不良反应发生率无统计学差异(RR=1.93,95%CI[0.76,4.87],P=0.16)。结论:小针刀治疗屈指肌腱狭窄性腱鞘炎有效,且与局部封闭治疗的安全性相当。今后仍需要开展更多高质量、大样本、长期随访的RCTs进一步验证其疗效与安全性。

Objective： To evaluate the efficacy and safety of acupotomy for trigger finger. Methods： We searched CNKI,CBM,VIP,Wanfang Data,Pub Med,Embase and The Cochrane Library databases. Randomized controlled trials（ RCTs） regarding acupotomy for trigger finger were included. The relevant data was pooled for the Meta- analysis by Rev Man 5. 3 software. Results： Sixteen RCTs involving 1857 participants were included in our systematic review. The pooled results indicated that acupotomy was superior to steroid injection in effective rate（ RR = 1. 28,95% CI[1. 15,1. 42],P 〈 0. 00001）,recurrence rate（ RR = 0. 14,95%CI [0. 08,0. 25],P 〈 0. 00001）,VAS score（ WMD =- 2. 85,95% CI [- 5. 38,- 0. 31],P = 0. 003）. There were no significant differences in adverse reactions（ RR = 1. 93,95% CI [0. 76,4. 87],P = 0. 16）. Conclusion： Acupotomy is effective and safe for trigger finger. RCTs with higher quality,larger sample sizes and longer follow- ups are needed in the future.