针刀治疗梨状肌综合征疗效的系统评价和Meta分析

Acupotomy Therapy for Piriformis Syndrome:ASystematic Review and Meta-analysis

目的:对针刀治疗梨状肌综合征的疗效与安全性进行系统评价。方法:计算机检索中国知网CNKI(1979/2019)、维普数据库VIP(1989/2019)、万方数据库Wanfang(1990/2019)、中国生物医学文献数据库CBM(1979/2019)、PubMed(1966/2019)、Cochranelibrary(Issue 1,2019)6个数据库中有关针刀治疗梨状肌综合征疗效的RCTs。2名研究者单独提取资料并交叉核对结果,然后根据Cochrane Handbook 5.1.0评估其质量,采用RevMan 5.3软件行统计学分析。结果:18个临床随机对照试验被纳入,合计1639例梨状肌综合征患者。Meta分析结果显示:针刀组总有效率[OR=5.54,95%CI(3.71,8.29),P<0.00001]、治愈率[OR=4.01,95%CI(2.88,5.59),P<0.00001]、VAS评分[MD=-0.53,95%CI(-0.75,-0.30),P<0.00001]、ODI评分[MD=-7.17,95%CI(-8.72,-5.61),P<0.00001]、即时止痛疗效[OR=4.31,95%CI(1.78,10.40),P=0.001]均优于对照组。结论:梨状肌综合征临床应用针刀疗法效果显著,且安全性可靠。但因本次采纳文献数量少且质量较低,仍需更多设计合理多中心的RCT加以验证。

Objective:To review systematically theclinicaleffectsand safety ofacupotomy therapy for piriformis syndrome.Methods:Randomizedcontrolled trials(RCTs)ofacupotomy therapy for piriformis syndrome were retrieved from CNKI(1979 to 2019),VIP(1989 to 2019),Wanfang(1990 to 2019),CBM(1979to2019),PubMed(1966to2019)and Cochranelibrary(Issue 1,2019).According to the requirements of the Cochrane Reviewers'Handbook,the two researchers separately extracted data and evaluated the quality of the literature,then cross-checked the results,and selected the Rev Man 5.3 software for Meta analysis.Results:18RCTs involving 1639 cases were included.The results of Meta-analysis showed the acupotomy group was superior to the control group in improving total effective rate[OR=5.54,95%CI(3.71,8.29),P<0.00001],cure rate[OR=4.01,95%CI(2.88,5.59),P<0.00001],VAS score[MD=-0.53,95%CI(-0.75,-0.30),P<0.00001],ODI score[MD=-7.17,95%CI(-8.72,-5.61),P<0.00001],instantly analgesic effect[OR=4.31,95%CI(1.78,10.40),P=0.001].Conclusion:Acupotomy therapy is effective for treating piriformis syndrome.However,The quality of the included literature is not high generally,based on the deficiency,our conclusion still needs to be comfirmed by more rigorously designed RCTs.