针刀治疗肌筋膜炎疗效和安全性的系统评价

发布时间：2018-02-24 08:35

本文关键词： 针刀肌筋膜炎系统评价 Meta分析　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：客观评价针刀治疗肌筋膜炎的疗效和安全性。方法：参考系统评价手册,制定文献纳入和排除标准,以及检索策略,查找文献。计算机检索万方、维普、中国生物医学文献数据库、相关期刊论文、PubMed、 Embase等数据库中的随机对照试验,经过文献筛选、资料提取、质量评价、meta分析、GRADE评级,然后客观评价针刀治疗肌筋膜炎的疗效。结果：本系统评价最终总共纳入13篇研究。其中有11篇研究为RCT,2篇研究为Q-RCT。总样本量为876例,其中实验组样本量为444例,对照组样本量为432例。纳入的13篇文章均对总有效率进行了总结,进行meta合并分析,结果显示针刀疗法或者针刀结合其它疗法对肌筋膜炎的治疗效果优于非针刀疗法。总有效率的GRADE评级为：Low!纳入的研究中只有1篇文献总结了治疗前后功能障碍积分,研究表明针刀在改善功能活动方面更有效,功能障碍积分的GRADE评级均为：Moderate!纳入文献中共有7篇文献总结了实验组和对照组治疗前后VAS评分情况,排除引起异质性的4篇文献后,再进行meta分析,结果显示针刀或者针刀结合其它疗法治疗肌筋膜炎在减轻疼痛方面的疗效优于对照组。VAS疼痛评分GRADE评级为：Moderate!纳入研究中共有3篇文献对复发率进行了总结,meta分析结果显示针刀疗法治疗肌筋膜炎相对非针刀疗法复发率更低。复发率的GRADE评级为：Moderate。对这13篇研究制作漏斗图,纳入文献均在可信区间之内,但是漏斗图不对称,说明存在发表偏倚的可能性较大。本系统评价纳入的13篇研究中,有3篇文献进行了安全性事件的描述,其余10篇文献均未描述安全性事件。所以针刀治疗本病的安全性是否可靠仍然需要更高质量的研究来进一步证实。结论：本系统评价得出的结论为针刀治疗肌筋膜炎确实安全有效。但是纳入研究的文献数量较少,方法学质量较低,故论证强度不够。得出的结论需审慎对待。
[Abstract]:Objective: to evaluate objectively the efficacy and safety of needle knife in the treatment of myofascitis. Random controlled trials in China Biomedical Literature Database, Chinese Journal Full-text Database, PubMedand Embase, etc., were evaluated by meta analysis and grade rating after literature screening, data extraction, quality evaluation, and so on. Then objective evaluation was made on the curative effect of acupuncture knife on myofascitis. Results: a total of 13 studies were included in this systematic evaluation, of which 11 were RCTs and 2 were Q-RCT.The total sample size was 876 cases, including 444 cases in the experimental group. In the control group, the sample size was 432 cases. The total effective rate was summarized in 13 articles, and the combined analysis of meta was carried out. The results showed that the therapeutic effect of needle knife therapy or needle knife combined with other therapy on myofascitis was better than that of non-needle knife therapy. The total effective GRADE rating was:: low! In the study, only one document summarized the score of dysfunction before and after treatment. The study showed that needle knife was more effective in improving functional activity, and the GRADE rating of the score of dysfunction was: moderate! A total of 7 articles were included in the literature. The VAS scores before and after treatment were summarized in the experimental group and the control group. After 4 articles of heterogeneity were excluded, meta analysis was carried out. The results showed that the therapeutic effect of needle knife or needle knife combined with other therapy in the treatment of myofascitis was better than that in the control group. VAS pain score GRADE rating was: moderate! The recurrence rate was summarized in 3 articles in the study. The results of meta analysis showed that the recurrence rate of needle knife therapy for myofascitis was lower than that of non-needle therapy. The GRADE rating of recurrence rate was: moderate. The included literatures were all within the confidence interval, but the funnel map was asymmetric, which indicated that there was a greater possibility of publication bias. Three of the 13 studies included in this systematic evaluation described the security events. The other 10 articles did not describe the safety events. Therefore, higher quality research is needed to further confirm the reliability of needle knife therapy for this disease. Conclusion: the conclusion of this systematic evaluation is that the acupuncture knife is used to treat muscle muscles and tendons. Meningitis is really safe and effective. But the literature involved in the study is relatively small. The quality of methodology is low, so the intensity of argumentation is not enough.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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