摘要
背景:目前尚缺乏冲击波治疗疼痛性肩关节挛缩症的证据。目的:系统评价体外冲击波治疗(ESWT)对疼痛性肩关节挛缩症的治疗作用。方法:计算机检索PubMed、ScienceDirect、The Cochrane Library、Embase、Web of knowledge、CNKI、万方、维普等数据库、会议资料、临床试验等中关于冲击波治疗疼痛性肩关节挛缩症的随机研究,检索时间均从建库至2016年5月10日。文献筛选关于体外冲击波治疗疼痛性肩关节挛缩症的随机对照试验(RCT)或随机对照交叉试验。采用RevMan 5.0软件进行Meta分析,并应用Stata11.0软件进行Berg检验及Egger检验来评估发表偏倚。连续性变量采用SMD及95%可信区间表示,二分类变量采用OR及95%可信区间表示。结果与结论:最终纳入11项研究,共816例受试者。(1)体外冲击波可有效减轻肩关节疼痛症状(P<0.05,I^2=54%);(2)除去药物治疗为对照的研究进行敏感性分析,结果无明显变化;(3)相对常规康复,体外冲击波治疗可更加有效扩大肩关节前屈、外展、内旋及外旋活动度。前屈(P<0.05,I^2=28%);外展(P<0.000 01,I^2=17%);内旋(P<0.05,I^2=0%);外旋(P<0.05,I^2=43%);冲击波治疗扩大肩关节后伸的证据不充分;(4)体外冲击波可提高疼痛性肩关节挛缩症治疗有效率(P<0.05,I^2=0.0%),以及治愈率(P<0.05,I^2=0.0%)。冲击波组与对照组脱落率无明显差异;(5)结果说明,体外冲击波可有效减轻疼痛性肩关节挛缩症疼痛症状,扩大肩关节前屈、外展及内外旋活动度,提高疼痛性肩关节挛缩症治疗有效率及治愈率。关键词:
BACKGROUND:There is a lack of evidence about the application of extracorporeal shock wave therapy(ESWT)in frozen shoulder contracture syndrome.OBJECTIVE:To systematically assess the effectiveness of ESWT for frozen shoulder.METHODS:A computer-based online search of PubMed,ScienceDirect,The Cochrane Library,Embase,Web of knowledge,CNKI,WanFang and CqVip databases was performed for articles related to ESWT for frozen shoulder published before May10,2016.Randomized controlled trials or randomized controlled crossover trials were screened.The Meta-analysis was conducted using RevMan5.0software,and publication bias was assessed by Berg and Egger tests on Stata11.0software.The continuous variables were expressed as standard mean difference(SMD)and95%confidence interval(CI),and binary variables were expressed as odds ratio(OR)and95%CI.RESULTS AND CONCLUSION:Eleven trials were enrolled involving816participants.ESWT could effectively alleviate shoulder pain(P<0.05,I2=54%).When excluded the trials of which control groups were medical interventions,the direction of the outcome did not change.ESWT was beneficial for the participants in terms of range of motion except extension,the changes in shoulder flexion(P<0.05,I2=28%),shoulder abduction(P<0.00001,I2=17%),shoulder internal rotation(P<0.05,I2=0%),shoulder external rotation(P<0.05,I2=43%).However,there is no evidence of the effectiveness of ESWT versus control(conventional therapy)for improving the range of shoulder extension.ESWT could increase the efficiency of treating frozen shoulder(P<0.05,I2=0.0%)and efficacy of curing frozen shoulder(P<0.05,I2=0.0%)compared with other interventions,and with no significant difference in the drop rate.These results indicate that ESWT can effectively alleviate the pain of frozen shoulder,expand the range of shoulder flexion,abduction,internal and external rotation,as well as improve the therapeutic efficiency and cure rate in the treatment of frozen shoulder.
作者
朱昌娥
魏嵘
章赛吉
陈文华
余波
Zhu Chang-e;Wei Rong;Zhang Sai-ji;Chen Wen-hua;Yu Bo(Department of Anesthesia, Children’s Hospital of Shanghai, Shanghai 200062, China;Department of Rehabilitation, Shanghai General Hospital, Shanghai 200080, China)
出处
《中国组织工程研究》
CAS
北大核心
2017年第28期4585-4592,共8页
Chinese Journal of Tissue Engineering Research
