非甾体类抗炎药治疗网球肘疗效的Meta分析

Efficacy of non-steroidal anti-inflammatory drugs in treatment of tennis elbow:a meta-analysis

目的系统评价非甾体类抗炎药治疗网球肘的疗效。方法计算机检索PubMed、EMbase、The Cochrane Library、VIP、CNKI和WanFang Data数据库,搜集关于非甾体抗炎药治疗网球肘的随机对照试验(RCT),检索时限均从建库至2019年5月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入8个RCT,包括595例患者。Meta分析结果显示:非甾体抗炎药与安慰剂[RR=1.10,95%CI(0.89,1.35),P=0.39]和非安慰剂对照有效率[RR=0.88,95%CI(0.77,1.00),P=0.06]的差异均无统计学意义。与非安慰剂对照相比,非甾体抗炎药治疗前后VAS评分差值反而更小[MD=-1.41,95%CI(-2.28,-0.53),P=0.002]。结论当前证据表明,非甾体抗炎药治疗网球肘疗效不确定,症状改善可能优于安慰剂,但不及其它治疗方法。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。

Objectives To systematically review the efficacy of non-steroidal anti-inflammatory drugs(NSAIDs) on tennis elbow. Methods PubMed, EMbase, The Cochrane Library, VIP, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials(RCTs) on NSAIDs for tennis elbow from inception to May2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then,meta-analysis was performed by using RevMan 5.3 software. Results A total of 8 RCTs involving 595 patients were included. The results of meta-analysis showed that there were no significant differences in the therapeutic effect between NSAIDs and the placebo group(RR=1.10, 95%CI 0.89 to 1.35, P=0.39) or non-placebo control group(RR=0.88, 95%CI0.77 to 1.00, P=0.06). Compared with non-placebo control group, NSAIDs group had lower VAS score difference(MD=-1.41, 95%CI-2.28 to-0.53, P=0.002). Conclusions Current evidence shows that the effect of NSAIDs on tennis elbow is still uncertain. The improvement of symptoms with NSAIDs may be superior to placebo, but inferior to other treatment methods. Due to the limited quantity and quality of included studies, the above conclusions are required to be verified by more high-quality studies.