目的:研究干针法对外上髁炎的治疗效果,并确定一种相对更有效的针刺技术。
方法:英文数据库(Pubmed,WebofScience,Scopus,EBSCO,ScienceDirect,泰勒和弗朗西斯,ProQuest,科克伦,奥维德,和Embase)和中文数据库(中国国家知识基础设施,万方,和VIP)进行了搜索。
方法:这项研究包括随机对照试验,以比较干刺与其他治疗方法治疗外上髁炎的有效性。主要结局指标是疼痛强度和肘部残疾,而次要结局指标包括握力和上肢功能。
方法:数据提取由两名研究人员进行,他们使用Cochrane偏倚风险分析工具和物理治疗证据数据库清单评估偏倚风险和纳入研究的方法学质量。建议的分级,评估,发展,采用评估方法对证据质量进行评估。
结果:本研究共纳入17项研究,涉及979名受试者。在治疗后1周内,干刺在改善外上髁炎患者的疼痛强度方面表现出显着优势(平均差异[MD]=-0.95,95%置信区间[CI],-1.88至-0.02)。在1周内和超过1周的随访中,干针治疗肘部残疾也有更好的改善(<1周:标准化平均差[SMD]=-1.37,95%CI,-1.88至-0.86;≥1周:SMD=-1.32,95%CI,-2.23至-0.4)和握力(<1周:SMD=0.27,95%CI,0.01至0.53;≥1周:SMD=0.45,95%CI0.02至0.88)。具有局部抽搐反应的触发点干针刺在1周内显示出更显着的疼痛强度改善(MD=-1.09,95%CI,-1.75至-0.44)。
结论:干刺对疼痛强度(1周内)有良好的治疗效果,函数,外上髁炎患者的握力和握力。局部抽搐反应在靶向触发点的治疗中是必要的。
OBJECTIVE: To investigate the therapeutic effects of dry needling on lateral epicondylitis and identify a relatively more effective needling technique.
METHODS: English databases (Pubmed, Web of Science, Scopus, EBSCO, ScienceDirect, Taylor & Francis, ProQuest, Cochrane, Ovid, and Embase) and Chinese databases (
China National Knowledge Infrastructure, Wanfang, and VIP) were searched.
METHODS: This study included randomized controlled trials for comparing the effectiveness of dry needling with other treatment methods for lateral epicondylitis. The primary outcome measures were pain intensity and elbow disability, while the secondary outcome measures included grip strength and upper limb function.
METHODS: Data extraction was performed by 2 researchers who used the Cochrane risk of bias analysis tool and the Physiotherapy Evidence Database checklist to assess the risk of bias and methodological quality of the included studies. The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to assess the quality of evidence.
RESULTS: A total of 17 studies that involved 979 subjects were included in this research. Dry needling exhibited a significant advantage in improving pain intensity among patients with lateral epicondylitis within 1 week after treatment (mean difference [MD]=-0.95, 95% confidence interval [CI], -1.88 to -0.02). Within 1 week and in the follow-ups that exceeded 1 week, dry needling also demonstrated better improvement in elbow disability (<1 week: standardized mean difference [SMD]=-1.37, 95% CI, -1.88 to -0.86; ≥1 week: SMD=-1.32, 95% CI, -2.23 to -0.4) and grip strength (<1 week: SMD=0.27, 95% CI, 0.01 to 0.53; ≥1 week: SMD=0.45, 95% CI, 0.02 to 0.88). Trigger point dry needling with local twitch response exhibited more significant improvement in pain intensity within 1 week (MD=-1.09, 95% CI, -1.75 to -0.44).
CONCLUSIONS: Dry needling demonstrates good therapeutic effects on pain intensity (within 1 week), function, and grip strength among patients with lateral epicondylitis. Local twitch response is necessary in treatment that targets trigger points.