Rookmoneea M, Dennis L, Brealey S, Rangan A, White B, McDaid C, Harden M
James Cook University Hospital, Marton Road, Middlesbrough, Teeside, UK.
J Bone Joint Surg Br. 2010 Sep;92(9):1267-72. doi: 10.1302/0301-620X.92B9.24282.
There are many types of treatment used to manage the frozen shoulder, but there is no consensus on how best to manage patients with this painful and debilitating condition. We conducted a review of the evidence of the effectiveness of interventions used to manage primary frozen shoulder using the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Physiotherapy Evidence Database, MEDLINE and EMBASE without language or date restrictions up to April 2009. Two authors independently applied selection criteria and assessed the quality of systematic reviews using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Data were synthesised narratively, with emphasis placed on assessing the quality of evidence. In total, 758 titles and abstracts were identified and screened, which resulted in the inclusion of 11 systematic reviews. Although these met most of the AMSTAR quality criteria, there was insufficient evidence to draw firm conclusions about the effectiveness of treatments commonly used to manage a frozen shoulder. This was mostly due to poor methodological quality and small sample size in primary studies included in the reviews. We found no reviews evaluating surgical interventions. More rigorous randomised trials are needed to evaluate the treatments used for frozen shoulder.
用于治疗肩周炎的方法有很多种，但对于如何以最佳方式治疗这种疼痛且使人衰弱的疾病，目前尚无共识。我们使用Cochrane系统评价数据库、效果评价文摘数据库、物理治疗证据数据库、MEDLINE和EMBASE对截至2009年4月的、用于治疗原发性肩周炎的干预措施有效性证据进行了回顾，检索时无语言或日期限制。两位作者独立应用选择标准，并使用多重系统评价评估（AMSTAR）工具评估系统评价的质量。对数据进行了叙述性综合分析，重点在于评估证据质量。总共识别并筛选了758篇标题和摘要，最终纳入了11篇系统评价。尽管这些系统评价大多符合AMSTAR质量标准，但仍缺乏足够证据就常用的肩周炎治疗方法的有效性得出确切结论。这主要是由于纳入评价的原始研究方法质量较差且样本量较小。我们未找到评估手术干预措施的评价。需要更严格的随机试验来评估用于治疗肩周炎的各种方法。
