目的 系统评价小针刀配合手法治疗肩关节周围炎(以下简称"肩周炎")的临床疗效.方法 计算机检索中国知识资源总库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊数据库(重庆维普)、中国学术期刊数据库(万方数据)、PubMed、Embase、Cochrane Library收录的小针刀配合手法治疗肩周炎临床随机对照试验相关文献.检索范围均为建库至2017年2月.2名研究者独立筛选文献、提取资料,按照Cochrane系统评价手册5.1.0对纳入文献进行质量评价,采用RevMan5.3软件进行Meta分析.结果 共纳入12篇文献,共计受试者1118例.Meta分析结果显示:与单纯手法治疗或手法配合针灸治疗比较,小针刀配合手法治疗肩周炎可明显提高临床总有效率[OR=5.07,95%CI(3.07,8.37),P<0.00001]和痊愈率[OR=2.89, 95%CI(2.21,3.78),P<0.00001],改善运动功能评分[MD=63.98,95%CI(38.61,89.35),P<0.00001],差异有统计学意义.结论 小针刀配合手法治疗肩周炎疗效确切.但纳入文献质量普遍偏低,尚需更多大样本、多中心、高质量的临床随机对照试验进一步验证.
Objective To systematically evaluate the efficacy of small-needle-knife therapy combined with manipulation in treating frozen shoulder. Methods Articles about small-needle-knife therapy combined with manipulation treating frozen shoulder clinical randomized controlled trials in CNKI, CBM, VIP, Wanfang Data, Embase, Cochrane Library and Pubmed database were searched. Retrieval time was from the establisment of the database to February 2017. Two researchers screened literature, extract materials independently. The quality of the included studies was evaluated according to the Cochrane System Evaluation Manual 5.1.0. Meta-analysis was performed by using RevMan 5.3 software. Results 12 articles were included in a systematic review, a total of 1118 cases of patients. Meta-analysis showed that, compared with small-needle-knife therapy alone, small-needle-knife therapy combined with manipulation in the treatment of frozen shoulder could significantly improve the total effective rate [OR=5.07, 95%CI(3.07, 8.37), P<0.000 01] and cure rate [OR=2.89, 95%CI(2.21, 3.78), P<0.000 01], enhance motor function score [MD=63.98, 95%CI(38.61, 89.35), P<0.000 01], with statistical significance. Conclusion Small-needle-knife therapy combined with manipulation had definite efficacy in the treatment of frozen shoulder. However, the quality of included research is relatively low, so large-sample, multi-center and high-quality randomized controlled trials are required for verification.