Department of Pain Management, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Anesthesiology, The First Affiliated Hospital of Chengdu Medical College, Xindu, Sichuan 610500, China.
Biomed Res Int. 2020 Mar 18;2020:1907821. doi: 10.1155/2020/1907821. eCollection 2020.
Osteoarthritis is the most common musculoskeletal disease. Extracorporeal shockwave therapy had shown an effect on osteoarthritis in both some animal experiments and clinical studies, but there was no systematic review to confirm the value of shockwave therapy in the treatment of all types of osteoarthritis and compare it with other traditional therapies (especially traditional Chinese medicine).
PubMed, Medline, the Cochrane Central Register of Controlled Trials, Web of Science, Chinese National Knowledge Infrastructure, WANFANG database, and VIP database were searched up to December 10, 2019, to identify randomized controlled trials comparing shockwave therapy and other treatments for osteoarthritis. Visual analogue scale and the Western Ontario and McMaster Universities Osteoarthritis Index were extracted and analyzed by RevMan and STATA software as outcomes of pain reduction and functional improvement. Adverse reactions were recorded to evaluate the safety of shockwave therapy.
Shockwave therapy had significant improvement in both pain reduction and functional improvement compared with placebo, corticosteroid, hyaluronic acid, medication, and ultrasound ( < 0.05). In functional improvement, shockwave therapy showed statistical improvement compared with kinesiotherapy and moxibustion ( < 0.05) but not with acupotomy surgery ( = 0.24). A significant difference between shockwave therapy and platelet-rich plasma was observed in pain reduction ( < 0.05) but not in functional improvement ( = 0.89). Meanwhile, a statistical difference was found between shockwave therapy and fumigation in functional improvement ( < 0.05) but not in pain reduction ( = 0.26). Additionally, there was no statistically significant difference between shockwave therapy and manipulation in both pain reduction ( = 0.21) and functional improvement ( = 0.45). No serious adverse reaction occurred in all of studies.
Extracorporeal shockwave therapy could be recommended in the treatment of osteoarthritis as a noninvasive therapy with safety and effectiveness, but the grade of recommendations needs to be discussed in a further study.
骨关节炎是最常见的肌肉骨骼疾病。体外冲击波疗法在一些动物实验和临床研究中显示对骨关节炎有疗效，但没有系统评价来确认冲击波疗法在治疗所有类型骨关节炎中的价值，并将其与其他传统疗法（尤其是中医）进行比较。
检索 PubMed、Medline、Cochrane 中心对照试验注册库、Web of Science、中国知网、万方数据库和维普数据库，查找截至 2019 年 12 月 10 日比较冲击波疗法与其他治疗骨关节炎的随机对照试验。使用 RevMan 和 STATA 软件提取和分析视觉模拟评分和西安大略和麦克马斯特大学骨关节炎指数，以评估疼痛减轻和功能改善的结局。记录不良反应以评估冲击波疗法的安全性。
与安慰剂、皮质类固醇、透明质酸、药物和超声相比，冲击波疗法在疼痛减轻和功能改善方面均有显著改善（<0.05）。在功能改善方面，冲击波疗法与运动疗法和艾灸相比有统计学意义（<0.05），但与针刀手术相比无统计学意义（=0.24）。冲击波疗法在疼痛减轻方面与富血小板血浆有显著差异（<0.05），但在功能改善方面无统计学意义（=0.89）。同时，冲击波疗法与熏蒸在功能改善方面有统计学差异（<0.05），但在疼痛减轻方面无统计学差异（=0.26）。此外，冲击波疗法与推拿在疼痛减轻（=0.21）和功能改善（=0.45）方面均无统计学差异。所有研究均未发生严重不良反应。
体外冲击波疗法作为一种安全有效的非侵入性治疗方法，可推荐用于骨关节炎的治疗，但需要进一步研究讨论推荐等级。
