Griswold David, Learman Ken, Ickert Edmund, Tapp Annie, Ross Omar
Department of Graduate Studies in Health and Rehabilitation Sciences, Youngstown State University, Youngstown, Ohio, USA.
Pain Med. 2023 Mar 1;24(3):285-299. doi: 10.1093/pm/pnac131.
The authors of this systematic review with meta-analysis evaluated the evidence for the effectiveness of various applications of dry needling (DN) combined with other conservative treatments for subacromial pain syndrome (SAPS).
Six databases (PubMED, CINAHL, Biosis, Web of Science, SPORTDiscus, and Cochrane Central Register of Controlled Trials) were searched after the study had been registered in PROSPERO. The authors included randomized clinical trials investigating the clinical effects of DN in combination with other conservative interventions for SAPS. Outcomes included pain and disability.
Eight studies were selected. All eight studies involving 10 comparisons were included in the analyses (N = 538). A random-effects model was used to analyze between-group effects. Dry needling performed in combination with other conservative interventions produced favorable outcomes at all time points for pain and disability. Standard mean differences ranged from -0.57 (moderate) to -1.29 (large) for pain and -0.69 (moderate) to -1.07 (large) for disability, favoring groups receiving DN in addition to conservative treatment. Four of the eight studies were rated as having unclear or high risk of bias.
The meta-analysis suggests that various applications of DN performed with other conservative interventions are more effective than conservative treatment alone for reducing pain and disability in patients with SAPS. Direct-comparison studies are needed to determine whether one application of DN is superior to another.
本系统评价及荟萃分析的作者评估了干针疗法（DN）联合其他保守治疗对肩峰下疼痛综合征（SAPS）有效性的证据。
在研究已在国际前瞻性系统评价注册平台（PROSPERO）注册后，检索了六个数据库（PubMed、护理学与健康领域数据库（CINAHL）、生物学文摘数据库（Biosis）、科学引文索引数据库（Web of Science）、体育与运动医学数据库（SPORTDiscus）和Cochrane对照试验中心注册库）。作者纳入了调查DN联合其他保守干预措施对SAPS临床疗效的随机临床试验。结局指标包括疼痛和功能障碍。
共纳入八项研究。所有八项研究涉及的10项比较均纳入分析（N = 538）。采用随机效应模型分析组间效应。DN联合其他保守干预措施在疼痛和功能障碍的所有时间点均产生了良好的结局。疼痛的标准均数差范围为-0.57（中度）至-1.29（重度），功能障碍的标准均数差范围为-0.69（中度）至-1.07（重度），支持除保守治疗外还接受DN治疗的组。八项研究中有四项被评为偏倚风险不明确或高。
荟萃分析表明，DN联合其他保守干预措施在减轻SAPS患者的疼痛和功能障碍方面比单纯保守治疗更有效。需要进行直接比较研究以确定一种DN应用是否优于另一种。
