针灸联合关节松动术治疗肩周炎的网状Meta分析

Network Meta-Analysis of Acupuncture Combined with Joint Mobilization in the Treatment of Frozen Shoulder

目的 运用网状Meta分析方法评价针灸联合关节松动术治疗肩周炎的疗效。方法 运用计算机检索Web of Science、PubMed、Cochrane Library、EMbase、维普(VIP)、中国知网(CNKI)、万方(Wanfang)、中国生物医学文献数据库(CBM),搜寻有关针灸联合关节松动术治疗肩周炎的随机对照试验。所有研究人员均独立纳排文献、提录资料、风险评估,对符合质量标准的RCT研究采用Stata16.0和Review Manager 5.4软件进行分析。结果 共检索出6561篇文献,最终纳入37项研究,涉及10种针灸联合关节松动术方法。总样本量2890例,其中试验组1432例,对照组1458例。网状Meta分析所得结果表明:(1)在总有效率方面,最好的3种治疗方法为内热针联合组、温针联合组、动筋针联合组;(2)在降低VAS评分方面,最好的3种治疗方法为内热针联合组、动筋针联合组、针刀联合组。结论 针灸联合关节松动术治疗肩周炎疗效总体优于单独使用,且内热针联合组具有最佳的疗效。

Objective Network Meta-analysis was used to evaluate the efficacy of acupuncture combined with joint mobilization in the treatment of frozen shoulder. Methods Web of Science, PubMed, Cochrane Library, Web of Science, EMbase, VIP, Chinese Knowledge Infrastructure(CNKI), Wanfang and CBM were searched by computer for randomized controlled trials on acupuncture combined with joint mobilization in the treatment of frozen shoulder. All researchers independently compiled the literature, extracted material, and evaluated quality, and studies that met the quality criteria were analyzed using Stata16.0 software and Review Manager 5.4. Results A total of 6561 articles were retrieved and finally 37 studies involving 10 acupuncture combined with joint mobilization methods were included. The total sample size was 2890, including 1432 in the experimental group and 1458 in the control group. The results showed that:(1)In terms of effective rate, the optimal first three interventions were Internal heat acupuncture joint group, warming acupuncture joint group, and moving tendon needle joint group.(2)In terms of reducing VAS score, the optimal first three interventions were Internal heat acupuncture joint group,moving tendon needle joint group, and acupotomy joint group. Conclusion The curative effect of acupuncture combined with joint mobilization in the treatment of frozen shoulder is generally better than that of single use, and the combination of internal heat acupuncture has the best curative effect.