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保守治疗拇外翻的调整间接和混合比较：系统评价和网络荟萃分析。

Adjusted Indirect and Mixed Comparisons of Conservative Treatments for Hallux Valgus: A Systematic Review and Network Meta-Analysis.

机构信息

College of Science & Technology, Ningbo University, Ningbo 315211, China.

Faculty of Sports Science, Ningbo University, Ningbo 315211, China.

出版信息

Int J Environ Res Public Health. 2021 Apr 6;18(7):3841. doi: 10.3390/ijerph18073841.

DOI:10.3390/ijerph18073841
PMID:33917568
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8038851/
Abstract

: Hallux valgus (HV) deformity is a common, potentially debilitating deformity. And evidence with high-quality for the conservative treatments of HV deformity is still required.; AIMS: To compare the effects of different conservative treatments for hallux valgus deformity by using the method of network meta-analysis.; : A systematic review and network meta-analysis of randomized controlled trials identified by searching PubMed, EMBASE, MEDLINE, OVID, and CINAHL. The included studies should have the characteristics that: (1) participants with hallux valgus deformity of any age (2) conservative treatments (3) Reported the hallux valgus (HVA), the intermetatarsal angle (IMA), the score of the Visual Analog Scale, and the score of Foot Function Index.; : 11 studies were included in this review. The agreement between reviewers reached a kappa value of 0.75. The results of the network meta-analysis showed that a combination of exercise and toe separator, night splints, and dry needling are most likely to be the best choice for reducing the hallux valgus angle (HVA) and intermetatarsal angle, and toe separators (with or without exercise), dry needling, and manipulation (with or without ice treatment) have advantages in improving the subjective feeling of patients.; : Multi-disciplinary conservative treatments have a great potential for hallux valgus deformity. More research with high-quality is needed to give a comprehensive and reasonable scheme of a holistic and long-term treatment protocol.

摘要

拇外翻（HV）畸形是一种常见的、潜在致残的畸形。仍然需要高质量的证据来支持 HV 畸形的保守治疗。

目的

通过网络荟萃分析的方法比较不同保守治疗拇外翻畸形的效果。

方法

通过搜索 PubMed、EMBASE、MEDLINE、OVID 和 CINAHL，对随机对照试验进行系统评价和网络荟萃分析。纳入的研究应具有以下特征：（1）任何年龄的拇外翻畸形患者；（2）保守治疗；（3）报告拇外翻角（HVA）、跖骨间角（IMA）、视觉模拟评分和足功能指数评分。

结果

本综述共纳入 11 项研究。两位审稿人的一致性达到了 0.75 的kappa 值。网络荟萃分析的结果表明，运动联合脚趾分离器、夜间夹板和干针疗法最有可能是降低拇外翻角（HVA）和跖骨间角的最佳选择，而脚趾分离器（联合或不联合运动）、干针疗法和手法（联合或不联合冰敷）在改善患者主观感受方面具有优势。

结论

多学科保守治疗对拇外翻畸形有很大的潜力。需要更多高质量的研究来制定一个全面合理的整体和长期治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/93e6b3513aaa/ijerph-18-03841-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/a56818259896/ijerph-18-03841-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/0fd088dec7f9/ijerph-18-03841-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/e5d48986b6a3/ijerph-18-03841-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/0760119e45fa/ijerph-18-03841-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/4b446b3c7501/ijerph-18-03841-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/9d79b2275a0a/ijerph-18-03841-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/3caa04606467/ijerph-18-03841-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/2c528cdbcb6c/ijerph-18-03841-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/0b564bef8d40/ijerph-18-03841-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/f620a025b59d/ijerph-18-03841-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/72889521b191/ijerph-18-03841-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/93e6b3513aaa/ijerph-18-03841-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/a56818259896/ijerph-18-03841-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/0fd088dec7f9/ijerph-18-03841-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/e5d48986b6a3/ijerph-18-03841-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/0760119e45fa/ijerph-18-03841-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/4b446b3c7501/ijerph-18-03841-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/9d79b2275a0a/ijerph-18-03841-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/3caa04606467/ijerph-18-03841-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/2c528cdbcb6c/ijerph-18-03841-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/0b564bef8d40/ijerph-18-03841-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/f620a025b59d/ijerph-18-03841-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/72889521b191/ijerph-18-03841-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f1/8038851/93e6b3513aaa/ijerph-18-03841-g012.jpg

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