针灸治疗肌腱病患者运动功能康复疗效的Meta分析

Meta-Analysis of Acupuncture Treatment on the Rehabilitation of Motor Function in Patients with Tendinopathy

目的系统评价针灸治疗肌腱病患者运动功能康复的临床疗效。方法检索EMbase、Pubmed、The Cochrane library、中国知网(CNKI)、万方数据、中国生物医学文献数据库(CBM)等数据库自建库起至2019年3月针灸治疗肌腱病临床疗效和安全性的随机对照试验(RCT),提取纳入文献的基本资料并评价其质量,用Revman 5.3软件进行Meta分析。结果最终纳入13篇RCT,591例患者。Meta分析结果显示:视觉模拟评分法(VAS)结果表明针灸治疗能够有效缓解肌腱病疼痛[1~3周组:WMD=-2.39,95%CI(-3.02,-1.76),P<0.01;4~12周组:WMD=-1.91,95%CI(-3.15,-0.67),P<0.01],压力疼痛阈值评分(PPT)测试表明针灸治疗能够有效提高肌腱病的压力痛阈[4~12周组:SMD=-2.89,95%CI(-3.79,-1.99),P<0.01],关节活动度评分(ROM)表明针灸治疗能够改善关节活动度[SMD=-0.29,95%CI(-0.56,-0.02),P<0.05]。森林结构图表明其结果稳健,漏斗图显示了其发表偏倚的可能性小。结论针灸治疗可降低肌腱病的疼痛,提高压力痛阈,改善关节活动度和运动功能,是治疗肌腱病的有效手段。

OBJECTIVE To systematically evaluate the clinical efficacy of acupuncture treatment on the rehabilitation of motor function in patients with tendinopathy.METHODS From the time of database establishment to March 2019,we searched and selected relevant literatures on randomized controlled trial(RCT)for the clinical efficacy and safety of acupuncture treatment on tendinopathy from electronic databases,including EMbase,Pubmed,The Cochrane library,China National Knowledge Infrastructure(CNKI),WANFANG DATA,and China Biology Medicine disc(CBM).Then the basic information of the included literature was extracted and evaluated for quality,and Meta-analysis was performed using Revman 5.3 software.RESULTS A total of 13 RCTs with 591 patients were included.The results of the Meta-analysis were as follows.The visual analog scale(VAS)showed that acupuncture treatment was effective in relieving tendinopathy pain[1-3 weeks group:WMD=-2.39,95%CI(-3.02,-1.76),P<0.01;4-12 weeks group:WMD=-1.91,95%CI(-3.15,-0.67),P<0.01].Besides,the pressure pain threshold score(PPT)test showed that acupuncture treatment was effective in improving the pressure pain threshold in tendinopathy[4-12 weeks group:SMD=-2.89,95%CI(-3.79,-1.99),P<0.01].In addition,the range of motion score(ROM)showed that acupuncture treatment was effective in improving the range of joint motion in tendinopathy[SMD=-0.29,95%CI(-0.56,-0.02),P<0.05].Moreover,forest structure plots indicated stable results,and funnel plots showed little publication bias.CONCLUSION Acupuncture treatment can reduce the pain of tendinopathy,increase the pressure pain threshold,as well as improve the range of joint motion and motor function,so it is an effective treatment for tendinopathy.