单一针刀疗法治疗肱骨外上髁炎有效性的Meta分析

Meta-Analysis of the Efficacy of Single-Needle Knife Therapy for Humerus Lateral Epicondylitis

摘要: 目的：使用Meta分析方法评价单一针刀疗法治疗肱骨外上髁炎患者的临床疗效。方法：计算机检索中国知网、万方、维普中文、中国生物医学文献、Embase、PubMed等数据库，检索时间为建库至2024年10月30日发表的针刀治疗肱骨外上髁炎的随机对照试验，根据纳入标准、排除标准、剔除标准筛选文献后，对文献进行数据采集并进行Meta分析。结果：纳入文献13篇，共计1109例患者，Meta分析显示，针刀疗法在有效率方面优于局部封闭疗法[RR = 1.16, 95% CI (1.10, 1.22), P < 0.0001]，但与冲击波疗法、针灸疗法相比无统计学差异；5项研究描述了VAS评分，[SMD = −0.51, 95% CI (−1.70, −0.68), Z = 0.84, P > 0.05]与非针刀组相比差异无统计学意义。结论：针刀疗法治疗肱骨外上髁炎有效率较高，能有效改善患者疼痛症状，纳入文章质量不高，期待未来开展更多高质量的随机对照试验以进一步验证针刀治疗肱骨外上髁炎的临床效果。

Abstract: Objective: To evaluate the clinical efficacy of single-needle knife therapy in patients with humerus lateral epicondylitis using meta-analysis methods. Methods: A computerized search was conducted in databases including China National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biology Medicine (CBM), Embase, and PubMed. The search covered records from the inception of the databases to October 30, 2024, for randomized controlled trials (RCTs) on needle knife therapy for humerus lateral epicondylitis. After applying inclusion, exclusion, and withdrawal criteria to filter the literature, data extraction was performed, followed by a meta-analysis. Results: A total of 13 articles involving 1109 patients were included. The meta-analysis indicated that needle knife therapy had a higher efficacy rate compared to Local Injection Therapy [RR=1.16, 95% CI (1.10, 1.22), P < 0.0001], but there was no statistically significant difference when compared with shock wave therapy or acupuncture. Five studies reported Visual Analogue Scale (VAS) scores, with a standardized mean difference [SMD = −0.51, 95% CI (−1.70, −0.68), Z = 0.84, P > 0.05], indicating no statistically significant difference compared to the non-needle knife group. Conclusion: Needle knife therapy has a higher efficacy rate in treating humerus lateral epicondylitis and can effectively improve patient pain symptoms. However, the quality of the included articles is not high, and more high-quality randomized controlled trials are expected in the future to further validate the clinical effects of needle knife therapy for humerus lateral epicondylitis.