基于文献评价的骶髂关节错位整复手法推荐级别研究

A Study on the Recommended Level of SACROILIAC Joint Malposition Reduction Techniques Based on Literature Evaluation

目的:通过针对骶髂关节错位整复手法的临床文献推荐级别评价研究,为临床治疗骶髂关节错位手法选择提供参考依据。方法:以计算机检索为主,检索出尽可能多的2000年~2019年的相关文献,通过Note Express、cochrane偏倚风险评价工具评价软件进行统计分析及文献评价。结果:初步检索文献346篇,最终纳入文献30篇,检索出符合推荐级别的主要整复手法10种,骶髂关节错位前错位推荐级别最高的为屈髋屈膝法,后错位则为后伸扳法。结论:骶髂关节错位前错位型临床选择推荐应用屈髋屈膝法,后错位型推荐应用后伸扳法。由于本研究符合纳入标准的文献质量普遍偏低,且文献发表存在偏倚,因此,尚需大样本、多中心的临床随机研究来进一步验证本治疗方法的有效性和安全性。

Objective: To improve the clinical diagnosis and treatment guideline of SACROILIAC joint disloca-tion by the evaluation of the clinical literature on the treatment of SACROILIAC joint dislocation. Methods: Computer-based retrieval was used to retrieve as many relevant literatures from 2000 to 2019 as possible, and statistical analysis and literature evaluation were carried out by means of Note Express and Cochrane Bias Risk Assessment Software. Results: A total of 346 articles and 30 articles were included, and 10 major reconstructive manipulations were found. The highest rec-ommended grade for SACROILIAC joint malposition was flexion of the hip and flexion of the knee, and that for posterior malposition was extension of the knee. Conclusion: The Anterior Malposition of SACROILIAC joint is recommended by bending the hip and bending the knee, and the posterior malposition is recommended by stretching and pulling. Because of the low quality of Literature and Publication Bias, large-sample, multi-center randomized clinical trials are needed to further validate the efficacy and safety of this therapy.