本文關鍵詞： 針刀 肌筋膜炎 系統(tǒng)評價 Meta分析　出處：《成都中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的：客觀評價針刀治療肌筋膜炎的療效和安全性。方法：參考系統(tǒng)評價手冊,制定文獻納入和排除標準,以及檢索策略,查找文獻。計算機檢索萬方、維普、中國生物醫(yī)學文獻數(shù)據(jù)庫、相關期刊論文、PubMed、 Embase等數(shù)據(jù)庫中的隨機對照試驗,經過文獻篩選、資料提取、質量評價、meta分析、GRADE評級,然后客觀評價針刀治療肌筋膜炎的療效。結果：本系統(tǒng)評價最終總共納入13篇研究。其中有11篇研究為RCT,2篇研究為Q-RCT�？倶颖玖繛�876例,其中實驗組樣本量為444例,對照組樣本量為432例。納入的13篇文章均對總有效率進行了總結,進行meta合并分析,結果顯示針刀療法或者針刀結合其它療法對肌筋膜炎的治療效果優(yōu)于非針刀療法。總有效率的GRADE評級為：Low!納入的研究中只有1篇文獻總結了治療前后功能障礙積分,研究表明針刀在改善功能活動方面更有效,功能障礙積分的GRADE評級均為：Moderate!納入文獻中共有7篇文獻總結了實驗組和對照組治療前后VAS評分情況,排除引起異質性的4篇文獻后,再進行meta分析,結果顯示針刀或者針刀結合其它療法治療肌筋膜炎在減輕疼痛方面的療效優(yōu)于對照組。VAS疼痛評分GRADE評級為：Moderate!納入研究中共有3篇文獻對復發(fā)率進行了總結,meta分析結果顯示針刀療法治療肌筋膜炎相對非針刀療法復發(fā)率更低。復發(fā)率的GRADE評級為：Moderate。對這13篇研究制作漏斗圖,納入文獻均在可信區(qū)間之內,但是漏斗圖不對稱,說明存在發(fā)表偏倚的可能性較大。本系統(tǒng)評價納入的13篇研究中,有3篇文獻進行了安全性事件的描述,其余10篇文獻均未描述安全性事件。所以針刀治療本病的安全性是否可靠仍然需要更高質量的研究來進一步證實。結論：本系統(tǒng)評價得出的結論為針刀治療肌筋膜炎確實安全有效。但是納入研究的文獻數(shù)量較少,方法學質量較低,故論證強度不夠。得出的結論需審慎對待。
[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.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.9

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本文編號：1529578