刮痧治疗颈肩痛的效果及安全性系统评价

Systemic evaluation of effect and safety of Guasha therapy for neck and shoulder pain

[目的]系统评价刮痧对颈肩痛的治疗效果和安全性,为临床推广刮痧疗法提供循证依据。[方法]应用计算机检索PubMed、EBSco、Web of Science、Cochrane图书馆4个英文数据库以及中国期刊全文数据库(CNKI)、万方科技期刊全文数据库(WanFang)、中国生物医学网(CBM)3个中文数据库中关于刮痧干预颈肩痛的随机对照试验,对纳入研究的文献进行偏倚风险评价,采用RevMan 5.3软件进行Meta分析。[结果]共纳入11项随机对照试验,涉及1 044例病人。Meta分析结果显示:刮痧疗法可有效地改善颈肩痛疗效[Rr=1.14,95%CI(1.08,1.19),P<0.000 01],提高颈部活动功能[MD=-6.11,95%CI(-10.44,-1.77),P=0.006],但在缓解病人疼痛方面差异无统计学意义[SMD=-1.51,95%CI(-3.06,0.04),P=0.06]。[结论]刮痧治疗颈肩痛安全、有效,但是由于纳入研究的数量和质量均不高,其确切疗效还需要大样本的随机对照试验来验证。

Objective：To systematically evaluate the therapeutic effect and safety of scraping on neck and shoulder pain,and provide evidence-based evidences for clinical promotion of scraping therapy.Methods：The literatures of randomized controlled trials（RCTs）of scraping intervention in neck and shoulder pain were retrieved from 4 English databases including PubMed,EBSco,Web of Science,and Cochrane Library,and 3 Chinese dctabases including China Journal Full-text Database（CNKI）,Wanfang Science and Technology Journal Full-text Database（WanFang）and China Biomedical Network（CBM）.The risk of the biased evaluation was included and the meta-analysis was performed by using the RevMan5.3 software.Results：A total of 11 RCTs involving 1 044 patients were included in this study.Meta-analysis showed that scraping therapy could effectively improve the neck and shoulder pain of patients[RR=1.14,95% CI（1.08,1.19）,P〈0.000 01],and improve the function of neck activity[MD=-6.11,95% CI（-10.44,-1.77）,P=0.006].However,there was no statistically significant difference in relieving pain in patients[SMD=-1.51,95% CI（-3.06,0.04）,P=0.06].Conclusions：Scrapping treatment of neck and shoulder pain was safe and effective.Due to the lower quantity and quality of the included studies,the exact curative effect need to be verified by large RCTs.