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目的:通过系统地评价临床随机对照实验,探求体外冲击波治疗肩部钙化性肌腱炎的最佳强度和剂量。方法:通过检索The Cochrane Central Register of Controlled Trials,EMBASE,Medline和SCI数据库,获得有关比较不同的强度和剂量的体外冲击波治疗肩部钙化性肌腱炎的临床随机对照实验(RCT)。分别独立应用纳入和排除标准评价检索到的文献,提取数据并评价每一纳入文献的方法学上的质量。将纳入研究的文献用Rev Man5.3进行分析。结果:8个比较高、低强度的体外冲击波疗效的临床随机实验(492人)显示,高强度的体外冲击波疗效显著好于低强度体外冲击波,合并后的RR=1.93,95%CI=1.44~2.59;6个比较高、低体外冲击波治疗剂量的临床随机实验(349人)显示,高剂量的体外冲击波疗效显著好于低剂量体外冲击波,合并的RR=1.71,95%CI=1.17~2.50.结论:体外冲击波在治疗肩部钙化性肌腱炎时强度在0.20~0.45 m J/m~2,治疗剂量在600~1 920 m J/m~2时疗效较好。
OBJECTIVE: To systematically evaluate clinical randomized controlled trials to explore the best intensity and dose of shock wave treatment of shoulder calcific tendinitis in vitro. METHODS: A randomized controlled trial (RCT) of Shock calcified tendonitis for the comparison of different intensities and doses of extracorporeal shock waves was performed by searching The Cochrane Central Register of Controlled Trials, EMBASE, Medline and SCI databases. Evaluate the retrieved documents separately using inclusion and exclusion criteria, extract data and evaluate the methodological quality of each included document. The included studies were analyzed using Rev Man 5.3. Results: Eight randomized trials (492 persons) of high and low intensity ESWT showed that high intensity extracorporeal shock wave was significantly better than low intensity extracorporeal shock wave (RR = 1.93, 95% CI = 1.44 ~ 2.59; six clinical randomized trials (349) of high and low ESWT doses showed that high dose of ESWB was significantly better than low dose of ESW combined with RR = 1.71, 95% CI = 1.17-2.50. CONCLUSION: The intensity of extracorporeal shock waves is 0.20-0.45 mJ / m ~ 2 at the treatment of calcific tendinitis of shoulder, and the therapeutic effect is good at the dose of 600-1 920 mJ / m ~ 2.