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超声引导药物注射疗法的疗效：一项系统评价与荟萃分析。

Efficacy of ultrasound-guided pharmacopuncture: A systematic review and meta-analysis.

作者信息

Lee Jinho, Lee Sook-Hyun, Lee Yoon Jae, Kim Ju Yeon, Heo In, Cho Jae-Heung, Seo Byung-Kwan, Ko Dong Kun, Ha In-Hyuk

机构信息

Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea.

Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea.

出版信息

Medicine (Baltimore). 2025 Mar 14;104(11):e41733. doi: 10.1097/MD.0000000000041733.

DOI:10.1097/MD.0000000000041733
PMID:40101074
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11922419/
Abstract

BACKGROUND

Pharmacopuncture, used for the treatment and management of musculoskeletal diseases, improves pain and functional outcomes. This study aimed to examine the practice trends, clinical effectiveness, and safety of ultrasound-guided pharmacopuncture for various conditions.

METHODS

All clinical studies across 11 databases on ultrasound-guided pharmacopuncture published before January 2024 were included, regardless of disease type and study design. Meta-analyses were conducted according to the Cochrane systematic review protocol using RevMan 5.4. The Grading of Recommendations, Assessment, Development, and Evaluation method was used for evidence-level rating.

RESULTS

From 16 studies with ultrasound-guided pharmacopuncture, 9 randomized clinical trials, 4 chart reviews, and 3 case studies were included. A total of 685 patients from 9 randomized clinical studies were included in the meta-analysis. For all diseases, the percentage of patients showing improvement in pain reduction in the ultrasound-guided pharmacopuncture group was higher than that in the unguided pharmacopuncture (risk ratio [RR]: 1.17; 95% confidence interval [CI]: 1.08-1.26) and usual care groups (RR: 1.23; 95% CI: 1.07-1.41). Subgroup analyses for lumbar disease revealed that the percentage of patients showing improvement was higher in the ultrasound-guided pharmacopuncture group than that in the unguided group (RR: 1.27; 95% CI: 1.13-1.44).

CONCLUSIONS

Ultrasound-guided pharmacopuncture is clinically effective for pain reduction and improvement of functional outcomes. Furthermore, the intervention groups reported fewer adverse events. For lumbar spine conditions, significant differences in pain reduction and improvement in functional disability outcomes were confirmed 1 week and 1 month after treatment, respectively. To verify the clinical effectiveness of ultrasound-guided pharmacopuncture with high levels of evidence, more high-quality and large-scale randomized controlled trials are needed.

摘要

背景

用于治疗和管理肌肉骨骼疾病的药物针灸可改善疼痛和功能预后。本研究旨在探讨超声引导下药物针灸在各种病症中的应用趋势、临床疗效及安全性。

方法

纳入2024年1月前在11个数据库中发表的所有关于超声引导下药物针灸的临床研究，不考虑疾病类型和研究设计。根据Cochrane系统评价方案，使用RevMan 5.4进行荟萃分析。采用推荐分级、评估、制定和评价方法进行证据水平评级。

结果

16项超声引导下药物针灸研究中，包括9项随机临床试验、4项病历回顾和3项病例研究。9项随机临床研究中的685例患者纳入荟萃分析。对于所有疾病，超声引导下药物针灸组疼痛减轻改善患者的百分比高于非引导药物针灸组（风险比[RR]：1.17；95%置信区间[CI]：1.08 - 1.26）和常规护理组（RR：1.23；95% CI：1.07 - 1.41）。腰椎疾病亚组分析显示，超声引导下药物针灸组改善患者的百分比高于非引导组（RR：1.27；95% CI：1.13 - 1.44）。

结论

超声引导下药物针灸在减轻疼痛和改善功能预后方面具有临床疗效。此外，干预组报告的不良事件较少。对于腰椎疾病，分别在治疗后1周和1个月证实疼痛减轻和功能残疾预后改善存在显著差异。为了以高水平证据验证超声引导下药物针灸的临床疗效，需要更多高质量、大规模的随机对照试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf5b/11922419/28a1553b3453/medi-104-e41733-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf5b/11922419/61195928d01e/medi-104-e41733-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf5b/11922419/29d64b86e539/medi-104-e41733-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf5b/11922419/28a1553b3453/medi-104-e41733-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf5b/11922419/61195928d01e/medi-104-e41733-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf5b/11922419/29d64b86e539/medi-104-e41733-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf5b/11922419/28a1553b3453/medi-104-e41733-g003.jpg

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Cochrane Database Syst Rev. 2021 Aug 26;8(8):CD009147. doi: 10.1002/14651858.CD009147.pub3.
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