Liu Lin, Huang Qiang-Min, Liu Qing-Guang, Thitham Nguyen, Li Li-Hui, Ma Yan-Tao, Zhao Jia-Min
Department of Sport Medicine and the Center of Rehabilitation, School of Sport Science, Shanghai University of Sport, Shanghai, China.
Department of Sport Medicine and the Center of Rehabilitation, School of Sport Science, Shanghai University of Sport, Shanghai, China; Department of Pain Rehabilitation, Shanghai Hudong Zhonghua Shipbuilding Group Staff-worker Hospital, Shanghai, China.
Arch Phys Med Rehabil. 2018 Jan;99(1):144-152.e2. doi: 10.1016/j.apmr.2017.06.008. Epub 2017 Jul 8.
To evaluate the current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with low back pain (LBP).
PubMed, Ovid, EBSCO, ScienceDirect, Web of Science, Cochrane Library, CINAHL, and China National Knowledge Infrastructure databases were searched until January 2017.
Randomized controlled trials (RCTs) that used dry needling as the main treatment and included participants diagnosed with LBP with the presence of MTrPs were included.
Two reviewers independently screened articles, scored methodologic quality, and extracted data. The primary outcomes were pain intensity and functional disability at postintervention and follow-up.
A total of 11 RCTs involving 802 patients were included in the meta-analysis. Results suggested that compared with other treatments, dry needling of MTrPs was more effective in alleviating the intensity of LBP (standardized mean difference [SMD], -1.06; 95% confidence interval [CI], -1.77 to -0.36; P=.003) and functional disability (SMD, -0.76; 95% CI, -1.46 to -0.06; P=.03); however, the significant effects of dry needling plus other treatments on pain intensity could be superior to dry needling alone for LBP at postintervention (SMD, 0.83; 95% CI, 0.55-1.11; P<.00001).
Moderate evidence showed that dry needling of MTrPs, especially if associated with other therapies, could be recommended to relieve the intensity of LBP at postintervention; however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remains unclear.
评估与腰痛（LBP）相关的肌筋膜触发点（MTrP）干针疗法有效性的现有证据。
检索了PubMed、Ovid、EBSCO、ScienceDirect、Web of Science、Cochrane图书馆、CINAHL以及中国知网数据库，检索截至2017年1月。
纳入以干针疗法作为主要治疗方法且纳入了诊断为LBP伴有MTrP的参与者的随机对照试验（RCT）。
两名研究者独立筛选文章、评估方法学质量并提取数据。主要结局为干预后及随访时的疼痛强度和功能障碍。
荟萃分析共纳入11项涉及802例患者的RCT。结果表明，与其他治疗相比，MTrP干针疗法在减轻LBP强度方面更有效（标准化均数差[SMD]，-1.06；95%置信区间[CI]，-1.77至-0.36；P = 0.003）以及功能障碍（SMD，-0.76；95% CI，-1.46至-0.06；P = 0.03）；然而，在干预后，干针疗法联合其他治疗对疼痛强度的显著效果可能优于单独使用干针疗法治疗LBP（SMD，0.83；95% CI，0.55 - 1.11；P < 0.00001）。
中等证据表明，MTrP干针疗法，尤其是联合其他疗法时，可推荐用于减轻干预后的LBP强度；然而，干针疗法在改善功能障碍及其随访效果方面的临床优势仍不明确。
