针灸与针刀治疗肩关节周围炎疗效比较的系统评价

目的:系统评价针灸与针刀治疗肩关节周围炎的疗效和安全性差异。方法:计算机检索中国生物医学文献数据库CBM(1978年—2010年)、中国知网CNKI(1979年—2010年)、维普数据库VIP(1989年—2010年)、PubMed(1966年—2010年)和Cochrane Library(2010年第4期),辅以手工检索相关期刊,纳入针灸与针刀比较治疗肩周炎的随机对照试验。由2名评价者按照Cochrane系统评价员手册4.2.8的要求独立提取资料并交叉核对,采用RevMan5.1软件进行Meta分析。结果:共纳入6个随机对照试验,包括570例患者,仅有1篇高质量文献。Meta分析结果:针刀组治疗肩周炎总有效率明显高于针灸组,OR=7.70,95%CI[2.58,22.99],Z=3.66,P0.01;针刀组治疗肩周炎痊愈率明显高于针灸组,OR=5.39,95%CI[3.48,8.32],Z=7.58,P0.01。结论:针刀治疗肩周炎疗效优于针灸。但本研究纳入试验数有限且文献质量较低,需设计更严格的随机对照试验来进一步验证上述结论。

Systematic review of acupuncture versus acupotomology for frozen shoulder

Objective: To evaluate the clinical efficacy and safety of acupuncture versus acupotomology for frozen shoulder.Methods: Randomized controlled trials(RCTs) of acupuncture versus acupotomology in the treatment of frozen shoulder were retrieved from CBM(1978 to 2010),CNKI(1979 to 2010),VIP(1989 to 2010),PubMed(1966 to 2010),and Cochrane Library(Issue 4,2010).And some relevant journals were manually searched.Data were extracted and evaluated by two reviewers independently according to Cochrane Reviewers’ Handbook.The Cochrane Collaboration’s RevMan5.1 software was used for meta-analyses.Results: 6 trials involving 570 cases were included.The results of meta-analyses showed the total effect rate of acupotomology for frozen shoulder is higher than acupuncture,OR=7.70,95%CI[2.58,22.99],Z=3.66,P<0.01.And the cure rate of acupotomology for frozen shoulder is higher than acupuncture,OR=5.39,95%CI[3.48,8.32],Z=7.58,P<0.01.Conclusion: Acupotomology is superior to acupuncture in the treatment of frozen shoulder.However,due to low quality of included studies,rigorously designed RCTs are needed to confirm the conclusions.