小针刀治疗屈指肌腱狭窄性腱鞘炎疗效的Meta分析

目的 :通过系统评价,比较小针刀疗法和封闭疗法治疗屈指肌腱狭窄性腱鞘炎的疗效以及安全性。方法 :检索中国知网(1962~2015年)、维普数据库(1993~2015年)、万方数据(2000~2015年)、pubmed中文数据库(1994~2015年),并且应用手工输入法检索相关医学期刊,纳入小针刀疗法与封闭疗法对比治疗屈指肌腱狭窄性腱鞘炎的随机对照试验,经2名评价者按要求对筛选后的资料进行交叉核对后,采用Rev Man 5.2软件进行Meta分析。结果:共纳入7个随机对照试验,包含患者1 174例,但没有筛选到高质量文献。Meta分析结果显示,小针刀组治疗屈指肌腱狭窄性腱鞘炎总有效率明显高于对照组,OR=9.07,95%CI[4.64,17.76],Z=6.44,P0.00001;小针刀组治疗屈指肌腱狭窄性腱鞘炎痊愈率明显高于对照组,OR=7.86,95%CI[5.75,10.74],Z=12.93,P0.00001。结论:小针刀治疗屈指肌腱狭窄性腱鞘炎疗效优于封闭疗法。由于纳入试验数目有限且文献质量较低,漏斗图表现出发表偏倚,需设计更严格的随机对照试验来进一步验证上述结论。

Meta-analysis of Curative Effect of Small Needle Knife Therapy on Stenosing Tenovaginitis of Flexor Digitorum

Objective:To compare the curative effect and safety of small needle knife therapy and blocking therapy on stenosing tenovaginitis of flexor digitorum by system evaluation. Methods:Randomized controlled trials on treatment of stenosing tenovaginitis of flexor digitorum by small needle knife therapy and blocking therapy as the contrast were retrieved from Chinese national knowledge infrastructure(1962 ~2015),VIP database(1993 ~2015),Wan Fang database(2000 ~2015) and Pub Med Chinese database(1994 ~2015) by computer,as well as related medical journals by manual work. The Meta- analysis was done by the Rev Man5.2 software after the selected data was cross checked by 2 valuators according to the requirements. Results:A total of 7 randomized controlled trials met the inclusion criteria,including 1 174 patients,but there was no high- quality literature. The results of Meta- analysis showed that the total effective rate of the small needle knife group was significantly higher than that of the control group,OR=9.07,95%CI[4.64,17.76],Z=6.44,P<0.00001 and the cure rate of the small needle knife group was significantly higher than that of the control group,OR=7.86,95% CI[5.75,10.74],Z=12.93,P<0.00001. Conclusion:The curative effect of small needle knife therapy was better than that of the control group. Since the study included a limited number of trials and the quality of the literature was not high,the funnel plot showed publication bias,so the conclusion need to be validated by more rigorous randomized controlled trials.