体外冲击波治疗跟痛症效果的Meta分析

Effects of excroproeal shock wave on the heel pain: A Meta-analysis

目的以Meta分析方法调查体外冲击波对跟痛症的治疗效果,为跟痛症的临床诊治提供循证医学证据。方法检索CHKD期刊全文数据库(CNKI)、万方医学期刊数据库、Pubmed数据库、Web of Science数据库及Cochrane Library数据库等。文献检索时间为自数据库建立起至2017年9月。严格按照纳入与排除标准筛选文献,纳入的临床随机对照试验中一组为采用疼痛视觉模拟评分(VAS)作为结果指标的体外冲击波治疗组。提取纳入文献的基本特征,包括冲击波治疗组的主要参数及VAS结局指标等。采用Cochrane协作组推荐的Cochrane偏倚风险评估工具对纳入文献的质量进行评价。采用Review Manager 5.2软件对统计分析变量进行Meta分析。结果共纳入3篇临床随机对照试验,包括312例跟痛症患者。Meta分析结果显示:体外冲击波组患者的VAS评分较对照组低(SMD=-1.51,95%CI:-1.65,-1.37,Z=21.28,P<0.01),病情改善率较对照组高(RR=2.43,95%CI:1.51,3.89,Z=3.68)。结论体外冲击波能有效减轻跟痛症患者的疼痛症状,提高患肢功能,改善患者的生存质量。

Objective To provide evidence for clinical treatment by Meta-analysis of randomized con- trolled trials of extracorporeal shock wave treatment of heel pain. Methods We searched China National Knowledge Infrastructure,Wanfang, Pubmed, Web of Science, Google Scholar and Coehrane Library databases, etc. All datebases were searched from their inception to September 2017. Set the inclusion criteria and exclusion criteria of the literature, and strictly follow the standards inclusion and exclusion literature, and retrieve the standard clinical randomized controlled trials on the treatment of heel pain. One of the included studies was an extraeorporeal shock wave treatment group and included Visual analogue scale （VAS） as a result indicator. Data extraction includes the basic characteristics of the study, the main parameters of the shock wave treatment group, VAS outcome indicators and so on. And the Cochrane Bias Risk Assessment Tool recommended by the Cochrane Colla-borative Group was used to evaluate the quality of the included studies. The Meta-analysis of statistical analysis was performed using Review Manager 5.2 software. Results A total of 3 articles of clinical randomized controlled trial and 312 patients heel pain were included. Meta-analysis showed that in vitro shock waves were able to reduce the VAS pain score in patients with heels compared with the control group （SMD = - 1.51,95 % CI： - 1.65 ,- 1.37, Z = 21.28,P 〈 0.01 ）, the condition of patients improved significantly （RR = 2.43 95% CI： 1.51,3.89 ）, Z = 3.68 ）. Conclusion External shock wave therapy can signifieantly reduce heel pain symptoms, improve limb function and the quality of life of patients.