单纯针刀治疗肌筋膜炎疗效与安全性的Meta分析

Meta-analysis of the Efficacy and Safety of Simple Acupotomy in the Treatment of Myofascitis

目的 系统评价小针刀治疗肌筋膜炎的疗效与安全性。方法 在中国知网(CNKI)、万方数据库(Wanfang Data)、中国生物医学文献数据库(CBM)、维普科技期刊数据库(VIP)、中国临床试验注册中心、Pubmed、Embase、Web Of Science、Cochrane Library、Clinical Trials中检索有关针刀治疗肌筋膜炎的临床随机对照试验,检索时限均从建库至2022年2月。由2名研究人员严格按纳排标准单独进行筛选文献、数据提取、偏倚风险评估后,采用RevMan5.3软件进行Meta分析。结果 最终纳入11篇文献,共1 125例患者,其中治疗组564例,对照组561例。经Meta分析,治疗组在总有效率[RR=1.20,95%CI=(1.14,1.25),P <0.00001]、疼痛视觉模拟评分[MD=-1.41,95%CI=(-1.72,-1.10),P <0.00001]、5-羟色胺[MD=-6.83,95%CI=(-7.11,-6.56),P <0.00001]及β-内啡肽[MD=3.53,95%CI=(2.99,4.07),P <0.00001]方面均优于对照组。结论 单纯针刀治疗肌筋膜炎的疗效优于传统针灸疗法,但由于文献质量总体偏低、缺少安全性记录等原因,此结论尚需设计高质量、大样本、多中心的随机对照试验予以验证。

Objective:To systematically evaluate the efficacy and safety of simple acupotomy in the treatment of myofascitis. Methods:The clinical randomized controlled trials of acupotomy treatment of myofascitis were searched in CNKI,Wangfang,CBM,VIP,China Clinical Trials Registration Center,Pubmed,Embase,Web Of Science,Cochrane Library and ClinicalTrials from inception to February 2022. Two researchers independently screened the literature,extracted data,and assessed risk of bias in strict accordance with inclusion and exclusion criteria,and then used RevMan5.3 software for meta-analysis. Results:A total of 11 articles were included,with a total of 1 125 patients,including 564 patients in the treatment group and 561 patients in the control group. Metaanalysis showed that the treatment group was superior to the control group in total effective rate[RR=1.20,95%CI=(1.14,1.25),P < 0.00001],reducing pain visual simulation score[MD=-1.41,95%CI=(-1.72,-1.10),P <0.00001],5-hydroxytryptamine[MD=-6.83,95%CI=(-7.11,-6.56),P < 0.00001]and β-endorphin[MD=3.53,95%CI=(2.99,4.07),P < 0.00001]. Conclusion:The efficacy of simple acupotomy in the treatment of myofascitis is better than that of traditional acupuncture,but due to the overall low quality of literature and the lack of safety records,this conclusion needs to be verified by designing high-quality,large-sample,multi-center randomized controlled trials.