温针灸联合关节松动术治疗肩关节周围炎疗效Meta分析

A Meta Analysis of Therapeutic Effect of Warming-Needle Acupuncture Combined with Joint Mobilization on Periarthritis of Shoulder

目的:系统评价温针灸联合关节松动术治疗肩关节周围炎(简称肩周炎)的治疗效果。方法:通过计算机检索建库至2019年8月的温针灸联合关节松动术治疗肩周炎的临床随机对照试验(RCT),数据库包括:中国知网数据库(CNKI)、Pub Med全文数据库、维普及万方等数据库,从筛选、纳入文献到质量评价和评估偏倚风险整个过程由2位工作员独立完成,并运用RevMan 5.3软件进行数据分析。结果:共纳入8篇RCT文献,总病例数646例,试验组323例,对照组323例,8篇文献显示,温针灸联合关节松动术有效率{MD=1.20,95%CI=[1.13,1.27],P<0.00001}及痊愈率{MD=1.62,95%CI=[1.35,1.94],P<0.00001}更高,亚组分析也显示,联合治疗疗效高于单一治疗。5篇文献提及VAS疼痛评分{MD=-1.05,95%CI=[-1.15,-0.95],P<0.00001},试验组在减轻肩周炎疼痛程度上优于对照组。结论:温针灸联合关节松动术在改善肩周炎疼痛及功能方面临床疗效确切,且安全性较高,但本研究文献存在样本量尚少、疗效判定标准及结局指标不统一等问题。

Objective:To systematically evaluate the therapeutic effect of warming-needle acupuncture combined with joint mobilization on periarthritis of shoulder.Methods:A randomized controlled clinical trial(RCT) on the treatment of periarthritis of shoulder by warming-needle acupuncture combined with joint mobilization was conducted by computer retrieval from building database to August 2019.The database included CNKI,PubMed full-text database,VIP and Wanfang database.The whole process from screening and inclusion of literature to quality evaluation and evaluation of bias risk was independently completed by two staff members,and Revman 5.3 Software was used for data analysis.Results:Eight RCT literatures were included,including 646 cases in total,323 cases in the experimental group and 323 cases in the control group.Eight literatures showed that the total effective rate {MD=1.20,95%CI=[1.13,1.27],P<0.000 01} and recovery rate {MD=1.62,95%CI=[1.35,1.94],P<0.000 01} of warming-needle acupuncture combined with arthrolysis were higher than those of single treatment.Five articles mentioned that VAS pain score {MD=-1.05,95%CI=[-1.15,-0.95],P<0.000 01},the experimental group was better than the control group in reducing the pain of periarthritis of shoulder.Conclusion:Warming-needle acupuncture combined with joint mobilization is effective and safe in improving the pain and function of periarthritis of shoulder.However,there are some problems in this study,such as the small sample size,the inconsistent criteria of efficacy and outcome,etc.