Meta-Analysis of Acupuncture Treatment on the Rehabilitation of Motor Function in Patients with Tendinopathy
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摘要:
目的 系统评价针灸治疗肌腱病患者运动功能康复的临床疗效。 方法 检索EMbase、Pubmed、The Cochrane library、中国知网(CNKI)、万方数据、中国生物医学文献数据库(CBM)等数据库自建库起至2019年3月针灸治疗肌腱病临床疗效和安全性的随机对照试验(RCT)，提取纳入文献的基本资料并评价其质量，用Revman 5.3软件进行Meta分析。 结果 最终纳入13篇RCT，591例患者。Meta分析结果显示：视觉模拟评分法(VAS)结果表明针灸治疗能够有效缓解肌腱病疼痛，压力疼痛阈值评分(PPT)测试表明针灸治疗能够有效提高肌腱病的压力痛阈，关节活动度评分(ROM)表明针灸治疗能够改善关节活动度。森林结构图表明其结果稳健，漏斗图显示了其发表偏倚的可能性小。 结论 针灸治疗可降低肌腱病的疼痛，提高压力痛阈，改善关节活动度和运动功能，是治疗肌腱病的有效手段。 Abstract:OBJECTIVE To systematically evaluate the clinical efficacy of acupuncture treatment on the rehabilitation of motor function in patients with tendinopathy. METHODS From the time of database establishment to March 2019, we searched and selected relevant literatures on randomized controlled trial (RCT) for the clinical efficacy and safety of acupuncture treatment on tendinopathy from electronic databases, including EMbase, Pubmed, The Cochrane library, China National Knowledge Infrastructure (CNKI), WANFANG DATA, and China Biology Medicine disc (CBM). Then the basic information of the included literature was extracted and evaluated for quality, and Meta-analysis was performed using Revman 5.3 software. RESULTS A total of 13 RCTs with 591 patients were included. The results of the Meta-analysis were as follows. The visual analog scale (VAS) showed that acupuncture treatment was effective in relieving tendinopathy pain. Besides, the pressure pain threshold score (PPT) test showed that acupuncture treatment was effective in improving the pressure pain threshold in tendinopathy. In addition, the range of motion score (ROM) showed that acupuncture treatment was effective in improving the range of joint motion in tendinopathy. Moreover, forest structure plots indicated stable results, and funnel plots showed little publication bias. CONCLUSION Acupuncture treatment can reduce the pain of tendinopathy, increase the pressure pain threshold, as well as improve the range of joint motion and motor function, so it is an effective treatment for tendinopathy. -
Key words:
- acupuncture /
- tendinopathy /
- systematic evaluation /
- meta-analysis /
- randomized controlled trial
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表 1 纳入文献的基本情况
纳入研究 诊断 例数(T/C) 年龄/岁 干预措施 随访时间/周 结局指标 T C Salom-More 2015[3] 踝关节韧带损伤 14/13 18~50 针灸疗法 本体感觉/力量训练 8 ① Chao Ma 2010[4] 斜方肌肌腱痛 30/28 18~80 针灸疗法 肌肉拉伸训练 2，12 ①③ Irene 2015[5] 慢性颈部疼痛 12/12 18~73 针灸疗法 骨科手法治疗 1，2 ①②③ Ziaeifar 2014[6] 斜方肌肌腱痛 16/17 20~48 针灸疗法 骨科手法治疗 1 ①② Yeganeh 2015[7] 斜方肌肌腱痛 20/20 18~30 针灸疗法 肌肉能量技术 1，2，3，4 ①②③ Cotchett 2014[8] 足底足跟痛 41/43 20~60 针灸疗法 安慰针灸疗法 2，4，6，12 ① Vzquez 2014[9] 急性颈部疼痛 9/8 20~60 针灸疗法 空白对照 1 ①②③ Pecosmartn 2015[10] 斜方肌肌腱痛 36/36 18~42 针灸疗法 安慰针灸疗法 1，4 ①② Sterling 2015[11] 慢性颈部扭伤 40/40 18~65 针灸疗法 非针灸疗法 1，6，12 ①② Seguraort 2016[12] 斜方肌肌腱痛 12/12 18~60 针灸疗法 肌肉拉伸训练 1，2，3 ①② Fabbro 2012[13] 跟腱炎 23/23 18~65 针灸疗法 安慰针灸疗法 12 ① Ferrero 2012[14] 肱骨外上髁炎 18/18 18~70 针灸疗法 肌肉拉伸训练 12 ① Ariasbura 2016[15] 肩关节痛 25/25 18~65 针灸疗法 力量训练 12 ① 注：T.针灸治疗组；C.非针灸治疗组; ①VAS；②PPT；③ROM。 
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