超声引导下针刀治疗肩周炎的有效性和安全性Meta分析

Effectiveness and Safety of Ultrasound-guided Acupotomy for Scapulohumeral Periarthritis:A Meta-analysis

目的 系统评价超声引导下针刀疗法治疗肩周炎(SP)的有效性、安全性。方法 计算机检索自建库至2023年12月31日中国知网(CNKI)、万方数据库(WANFANG DATA)、中国科技期刊数据库(VIP)、PubMed、荷兰医学文摘数据库(EMBASE)和Cochrane Library数据库等中英文数据库搜集超声引导下针刀疗法治疗SP的RCT,试验组为超声引导下针刀治疗SP,对照组为常规针刀。对纳入研究的文献运用Jadad量表、Cochrane偏倚风险表进行质量学评价,并采用RevMan5.4软件对统计的数据进行Meta分析。结果 共纳入18项研究,合计1 445例SP患者。Meta分析结果显示,超声引导下针刀治疗SP总有效率[Z=6.21,RR=1.16,95%CI(1.11,1.22),P <0.000 01]、视觉模拟评分[Z=8.11,SMD=-1.92,95%CI(-2.39,-1.46),P <0.000 01]、肩关节功能评分[Z=4.56,SMD=1.79,95%CI(1.02,2.56),P <0.000 01]方面均优于常规针刀。结论 基于现有证据,超声引导下针刀治疗SP具有较好的疗效,但本研究纳入分析的文献质量有限,上述结论仍需更多高质量的试验予以验证。

Objective:To systematically evaluate the efficacy and safety of ultrasound-guided acupotomy for scapulohumeral periarthritis(SP).Methods:Computerized searches were conducted from database inception to December 31,2023,in Chinese databases such as CNKI,WANFANG DATA,VIP,and English databases including PubMed,EMBASE,and Cochrane Library for randomized controlled trials(RCTs)on ultrasound-guided acupotomy for SP.The intervention group received ultrasound-guided acupotomy for SP,while the control group received conventional acupotomy.The quality of included studies was assessed using the Jadad scale and Cochrane risk of bias tool,and statistical data were analyzed using RevMan 5.4 software for meta-analysis.Results:Eighteen studies with a total of 1445 patients with SP were included.Meta-analysis results showed that ultrasound-guided acupotomy had better overall efficacy[Z=6.21,RR=1.16,95%CI(1.11,1.22),P<0.00001],visual analog scale scores[Z=8.11,SMD=-1.92,95%CI(-2.39,-1.46),P<0.00001],and shoulder joint function scores[Z=4.56,SMD=1.79,95%CI(1.02,2.56),P<0.00001]compared with conventional acupotomy.Conclusion:Based on current evidence,ultrasound-guided acupotomy for SP appears to be effective.However,due to the limited quality of included studies,these conclusions require further validation through more high-quality trials.