世界中医药

作者	单位
马诗凝1 尚青华2 付达尔丽1 罗智超1	1 北京中医药大学，北京，100029； 2 中国中医科学院西苑医院心血管科，北京，100091

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中文摘要:

目的：系统评价针刀与局部痛点封闭疗法治疗肩关节周围炎的安全性和有效性。方法：计算机检索中国生物医学文献数据库CBM（1978—2013年）、中国知网CNKI（1979—2013年）、维普数据库VIP（1989—2013年）、PubMed（1966—2013年）和Cochrane Library（2013年第5期），辅以手工检索相关期刊，纳入封闭与针刀比较治疗肩周炎的随机对照试验。由2名评价者按照Cochrane系统评价员手册的要求独立提取资料并交叉核对，如果有必要，将采用RevMan5.2.5软件进行Meta分析。结果：共纳入2个随机对照试验，包括115例患者，均为低质量文献。Meta分析结果显示：封闭组与针刀组相比，在治疗后痊愈率方面［OR=0.50，95%CI(0.16，1.63)，P=0.25］无统计学意义。但在远期总有效率方面［OR=0.09，95%CI(0.01，0.93)，P=0.04］，在远期痊愈率方面［OR=0.07，95%CI（0.02，0.26），P<0.0001］均有显著的统计学意义。结论：针刀治疗肩周炎的远期有效率和痊愈率的疗效可能更优于封闭。但本研究纳入试验数有限且文献质量较低，需设计更严格的随机对照试验来进一步验证上述结论。

English Summary:

To evaluate the clinical safety and efficacy of blockage and acupotomology for frozen shoulder. Methods： Randomized controlled trials（RCTs）on blockage and acupotomology in the treatment of frozen shoulder were retrieved from CBM ( from year 1978 to 2013), CNKI (from year 1979 to 2013), VIP (from year 1989 to 2013), PubMed ( from year 1966 to 2013), and Cochrane Library (Issue,5,2013). Data were extracted and evaluated by two reviewers independently according to Cochrane Reviewers’ Handbook. The Cochrane Collaboration’s Revman 5.2.5 software was used for meta-analyses when necessary. Results： Two trials involving 115 cases were included in the review. The results of meta-analyses showed that there was no significant difference of short-term curative rate for frozen shoulder between blockage and acupotomology (P>0.05). And the long-term effect rate ［OR=0.09，95%CI (0.01，0.93)，P=0.04］ and long-term total curative rate ［OR=0.07，95%CI（0.02，0.26），P<0.0001］ of acupotomology was superior to blockage in the treatment of frozen shoulder. Conclusion： Acupotomology may be superior to blockage in the treatment for frozen shoulder. However, due to low quality of the included studies, rigorously designed RCTs are needed to confirm the conclusion.

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