温针灸联合功能锻炼治疗肩周炎的meta分析

来源:用户上传      作者:田职瑜 龙安国

　　[摘要] 目的通过 meta 分析对温针灸联合功能锻炼治疗肩周炎的疗效进行评定。方法通过检索建库截至 2021年 7月中国知网、维普、万方、PubMed 数据库，纳入符合标准的文献，文献质量评价运用 Cochrane 偏倚风险评价表， meta 分析通过Revman 5.4软件进行。结果纳入符合标准的文献13篇，观察组和对照组各590例。 meta 分析结果显示温针灸联合功能锻炼治疗肩周炎的总有效率、肩部疼痛评价（视觉模拟评分、目前疼痛程度）、肩关节活动度方面均高于对照组（ P <0.05）。结论温针灸联合功能锻炼治疗肩周炎在减轻疼痛，改善肩关节活动度方面疗效确切。但本结论受纳入文献质量和样本量等的影响，需要更多研究方案全面的 RCT 支持。
　　[关键词] 温针灸;功能锻炼;肩周炎; meta 分析
　　[中图分类号] R-1; R246.9 [文献标识码] A [文章编号] 2095-0616（2022）06-0061-04
　　Meta-analysis of warm acupuncture and moxibustion combined with functional exercise in the treatment of scapulohumeral periarthritis
　　TIAN Zhiyu LONG Anguo
　　Department of Acupuncture， Massage and Rehabilitation， Changde Hospital Affiliated to Hunan University of Chinese Medicine， Hunan， Changde 415000， China
　　[Abstract] Objective To evaluate the efficacy of warm acupuncture and moxibustion combined with functional exercise in the treatment of scapulohumeral periarthritis by the meta-analysis system. Methods The databases of CNKI， Wanfang， VIP and PubMed were searched from the establishment of the databases to July 2021. The relevant literatures were screened out according to the established inclusion and exclusion criteria. The quality of the included literatures was evaluated with reference to the Cochrane risk of bias assessment standard， and RevMan 5.4 software was utilized for meta-analysis. Results A total of 13 literatures were included， including 590 cases in the observation group and 590 cases in the control group. The results of meta-analysis showed that the total effective rate， shoulder pain score （visual analog score and current pain degree） and shoulder range of motion for patients undergoing warm acupuncture and moxibustion combined with functional exercise in the treatment of scapulohumeral periarthritis were higher than those of the control group （P <0.05）. Conclusion Warm acupuncture and moxibustion combined with functional exercise in the treatment of scapulohumeral periarthritis is effective in reducing pain and improving shoulder range of motion. However， due to the small total sample size and low literature quality in this study， this conclusion needs to be further verified by more high-quality RCTs.
　　[Key words] Warm acupuncture and moxibustion; Functional exercise; Scapulohumeral periarthritis; Meta-analysis
　　肩周炎是骨科最常的一种疾病[1]，是指肩关节囊与其周围软组织出现慢性无菌性炎症和软组织广泛粘连，以肩部疼痛和日益严重的活动困难为主[2]。目前，西医治疗分为两类，一类为药物治疗，另一类为外科治疗，包括麻醉下手法松解、关节镜下松解术等[1]。中医将肩周炎归属“漏肩风”“痹症”等范畴，精血虚损，不能荣筋为内因;劳损、风寒湿邪侵袭为外因[3]。治疗包括中药的内服与外用、温针灸、蜡疗、小针刀等。近年来，温针灸联合功能锻炼治疗肩周炎积累了一定的经验，但缺乏系统性评价，故检索文献进行 meta 分析，旨在评价温针灸联合功能锻炼对肩周炎患者的治疗效果。

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