针灸治疗肩周炎的系统评价

目的：系统评价针刺治疗肩周炎的有效性及安全性。方法：以针刺、电针、针灸和肩周炎、肩凝症、冻结肩等为主题词，检索Cochrane骨关节病组，Cochrane临床试验资料库，Cochrane补充医学资料库，Cochrane图书馆中心数据库，MEDLINE，EMBASE等英文数据库和中国生物光盘数据库（CBM）等中文数据库。手工检索20种中医杂志及有关学术会议论文汇编。鉴定的相关文章附录的参考文献作为补充检索。结果：6个针刺及电针治疗肩周炎的随机对照试验符合纳入标准，均为较高质量研究。所纳入的人员数量从34人到257人，共668人。整体功能CMS／CSA评分汇总OR3．49（95％CI-2．64 to 9．63），疼痛VAS评分汇总OR-1．24（95％CI-3．50 to 1．01），肩关节活动范围ROM评分OR35．70（95％CI 22．91 to 48．49），肩关节功能4活动MELLE评分OR4．30（95％CI2．32 to 7．98）。结论：目前有限的纳入研究显示针刺治疗肩周炎安全，对改善整体功能、疼痛、肩关节活动范围、肩关节功能活动较对照组有效，尚需更多高质量的研究以使证据强度更高。对针刺治疗肩周炎的其他评价指标的有效性尚需要更多的研究证实。

REVIEW OF ACUPUNCTURE FOR FROZEN SHOULDER

Objective To assess the efficacy and possible adverse effects of acupuncture on frozen shoulder. Methods Based on the key words, i.e. Acupuncture, electroacupuncture, acupuncture-moxibustion,frozen shoulder, adhesive capsulitis, shoulder disorders etc., the Chinese databases were retrieved, including Cochrane Musculoskeleta Group, Cochrane Controlled Trials Register, Cochrane Complementary Medicine Field, and the central database of the Cochrane Library as well as MEDLINE, EMBASE and Chinese Biomedical CD (CBM-disc). 20 Chinese medical journals and relevant academic conference proceedings have been searched manually. The reference lists of identified documents were checked as the supplementary retrieval. Results 6 randomized controlled trials on frozen shoulder with acupuncture and electroacupuncture were included, indicating quite advanced study quality. There were 34 to 257 participants in the trials, 668 in total. The total OR of CMS/CSA was OR 3.49 (95% CI-2.64 to 9.63), the total OR of VAS was OR - 1.24 (95% CI -3.50 to 1.01), the total OR of ROM was OR 35.70 (95% CI 22.91 to 48.49); the total OR of MELLE was OR 4.30 (95% CI 2.32 to 7.98). Conclusion It is shown in the present limited inclusive trials on frozen shoulder that acupuncture is the safe therapy and effective on improving the global function, relieving pain, and improving the range of motion of shoulder. All the therapeutic effects of acupuncture are superior to those in control group. However, much more high quality trials are required to provide much stronger evidence. Additionally, much more evidences on validity of frozen shoulder with other assessing indexes involved are required in the treatment with acupuncture.