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针刺在肱骨骨折患者管理中的应用:系统评价和荟萃分析。

The Use of Acupuncture in the Management of Patients With Humeral Fractures: A Systematic Review and Meta-analysis.

机构信息

Department of Rehabilitation Medicine of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.

Department of Rehabilitation Medicine of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.

出版信息

J Manipulative Physiol Ther. 2021 Feb;44(2):146-153. doi: 10.1016/j.jmpt.2020.09.001. Epub 2021 Jan 9.

Abstract

OBJECTIVE

The purpose of this study was to conduct a systematic review and meta-analysis of the effects of acupuncture on humeral fractures.

METHODS

Randomized controlled trials were searched systematically from inception to January 2020 using the Cochrane Central Register of Controlled Trials, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, and 7 Korean databases. Pain scale and Japanese Orthopaedic Association scores were the primary and secondary measurements. A risk-of-bias assessment and meta-analysis were conducted.

RESULTS

Seven randomized controlled trials were included in the systematic review; the quality of the studies was ambiguous. The meta-analysis showed that acupuncture improved the pain severity score compared with conventional therapies (standard mean difference = -4.55, 95% confidence interval, -7.48 to -1.61, I = 98%, P < .00001) but did not improve the Japanese Orthopaedic Association score (standard mean difference = 4.99, 95% confidence interval, -0.31 to 10.30, I = 99%, P < .00001).

CONCLUSION

Our meta-analysis shows that acupuncture reduced pain after proximal humeral fracture, in addition to common rehabilitative modalities. However, the conclusion of this review should be cautiously applied in clinical practice owing to the low quality of the included studies.

摘要

目的

本研究旨在对针灸治疗肱骨骨折的效果进行系统评价和荟萃分析。

方法

系统检索了从成立到 2020 年 1 月的 Cochrane 对照试验中央注册库、Embase、PubMed、Web of Science、中国知网和 7 个韩国数据库,采用疼痛量表和日本矫形协会评分作为主要和次要测量指标。进行了风险偏倚评估和荟萃分析。

结果

系统综述纳入了 7 项随机对照试验;研究质量存在不确定性。荟萃分析显示,与常规疗法相比,针灸可改善疼痛严重程度评分(标准均数差=-4.55,95%置信区间:-7.48 至-1.61,I²=98%,P<0.00001),但对日本矫形协会评分无改善(标准均数差=4.99,95%置信区间:-0.31 至 10.30,I²=99%,P<0.00001)。

结论

我们的荟萃分析表明,除了常规康复手段外,针灸还可以减轻肱骨近端骨折后的疼痛。然而,由于纳入研究的质量较低,本综述的结论在临床实践中应谨慎应用。

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