体外冲击波治疗肩部钙化性肌腱炎疗效的Meta分析

Meta Analysis of Extracorporeal Shock Wave Therapy in the Treatment of Shoulder Calcific Tendinitis

目的:通过系统地评价临床随机对照实验,探求体外冲击波治疗肩部钙化性肌腱炎的最佳强度和剂量。方法:通过检索The Cochrane Central Register of Controlled Trials,EMBASE,Medline和SCI数据库,获得有关比较不同的强度和剂量的体外冲击波治疗肩部钙化性肌腱炎的临床随机对照实验(RCT)。分别独立应用纳入和排除标准评价检索到的文献,提取数据并评价每一纳入文献的方法学上的质量。将纳入研究的文献用Rev Man5.3进行分析。结果:8个比较高、低强度的体外冲击波疗效的临床随机实验(492人)显示,高强度的体外冲击波疗效显著好于低强度体外冲击波,合并后的RR=1.93,95%CI=1.44~2.59;6个比较高、低体外冲击波治疗剂量的临床随机实验(349人)显示,高剂量的体外冲击波疗效显著好于低剂量体外冲击波,合并的RR=1.71,95%CI=1.17~2.50.结论:体外冲击波在治疗肩部钙化性肌腱炎时强度在0.20~0.45 m J/m^2,治疗剂量在600~1 920 m J/m^2时疗效较好。

Objective：To explore the best intensity and dose of extracorporeal shock wave therapy for shoulder calcific tendonitis through the system evaluation of randomized controlled trials. Methods：By retrieving The Cochrane Central Register of Controlled Trials,EMBASE, Medline and SCI databases, the clinical randomized controlled trials（RCT）articles about different intensity and dose of extracorporeal shock wave treating shoulder calcific tendinitis were collected. The articles were evaluated separately using the inclusion and exclusion criteria, and the data were extracted and the methodological quality of each included literature was evaluated. The literature included in the study was analyzed by Rev ManS. 3. Results：Eight randomized clinical trials （492 patients） comparing the efficacy of extracorporeal shock wave with different intensity showed that high intensity extracorporeal shock wave was significantly better than low intensity extracorporeal shock wave, with combined RR= 1.93 and combined 95 %CI= 1.44-2.59. Six randomized clinical trials （349 patients） comparing the efficacy of extracorporeal shock wave with different dose showed that the high dose extracorporeal shock wave was significantly better than the low dose extracorporeal shock wave, with combined RR = 1. 71 and combined 95%CI= 1.17-2.50. Conclusion.. Extracorporeal shock wave has a better effect in the treatment of shoulder calcifying tendinitis when the intensity is 0.20-0.45 mJ/m2 and the dose is 600-1 920 mJ/m2.