| 李小芒,陈阳广,邓丽妮,唐友娟,陈运香.类固醇激素肩关节注射对偏瘫肩痛康复效果的Meta分析[J].中国康复,2021,36(10):612-618 |
| 类固醇激素肩关节注射对偏瘫肩痛康复效果的Meta分析 |
| Effectiveness of steroids injection in sub-acromial or intra-articular shoulder for hemiplegic shoulder pain treatment: a meta-analysis |
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| DOI： |
| 中文关键词: 类固醇激素 肩痛 脑卒中 康复 Meta分析 |
| 英文关键词: steroid shoulder pain stroke rehabilitation Meta-analysis |
| 基金项目:广西高校中青年教师基础能力提升项目（2017KY0498） |
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| 中文摘要: |
| 目的：评价类固醇激素肩关节注射对偏瘫肩痛（HSP）患者的康复效果，为HSP康复提供循证依据。方法：计算机检索Web of Science、EMBASE、The Cochrane Library、PubMed、中国知网（CNKI）、万方数据库、维普数据库（VIP）中从建库至2020年7月发表的有关类固醇激素与空白/安慰剂肩关节注射疗效比较的随机对照试验（RCT）。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用RevMan 5.3和StataSE 12.0软件进行统计分析。结果：最终纳入9篇文献，其中英语文献5篇，中文文献4篇，共416人。与空白/安慰剂相比，类固醇激素肩关节注射可以显著降低HSP患者的疼痛［SMD＝0.93，95%CI（0.71，1.14），Z＝8.46，P<0.01］，改善日常生活活动能力［SMD＝-0.42，95%CI（-0.65，-0.20），Z＝3.71，P＝0.0002］和上肢运动功能［SMD＝-1.02，95%CI（-1.68，-0.36），Z＝3.02，P＝0.003］，提高肩关节前屈［MD＝-15.41，95%CI（-23.30，-7.52），Z＝3.83，P=0.0001］、外展［MD＝-12.16，95%CI（-15.67，-8.65），Z＝6.79，P<0.01］、外旋［MD＝-8.47，95%CI（-9.94，-7.00），Z＝11.30，P<0.01］和内旋ROM［MD＝-2.95，95%CI（-4.57，-1.32），Z＝3.56，P＝0.0004］。结论：类固醇激素肩关节注射能安全、有效地促进降低HSP患者疼痛，促进上肢功能康复。 |
| 英文摘要: |
| Objective: To provide evidence-based basis for hemiplegic shoulder pain (HSP) rehabilitation and evaluate the efficacy of steroids injection for HSP treatment. Methods: An extensive search of related literature from Web of Science, EMBASE, The Cochrane Library, PubMed, CNKI, Wanfang, VIP database was performed from the inception to July 2020. The randomized controlled trails (RCTs) comparing the effects of steroids injection in sub-acromial or intra-articular shoulder with blank/placebo were collected. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then meta-analysis was performed by using RevMan 5.3 software and StataSE12.0. Results: Totally, 9 RCTs including 416 cases were finally included with 5 English articles and 4 Chinese articles. As compared with blank/placebo group, HSP patients’ pain was significantly reduced ［SMD＝0.93, 95%CI (0.71, 1.14), Z=8.46, P<0.01］, activities of daily living ［SMD=-0.42, 95%CI (-0.65, -0.20), Z=3.71, P=0.0002］ and functional level of upper extremity significantly improved ［SMD＝-1.02，95%CI（-1.68，-0.36），Z＝3.02，P＝0.003］, and shoulder flexion ［MD＝-15.41, 95%CI (-23.30, -7.52), Z=3.83, P=0.0001］, abduction ［MD=-12.16, 95%CI (-15.67, -8.65), Z=6.79, P<0.01］, external rotation ［MD＝-8.47, 95%CI (-9.94, -7.00), Z=11.30, P<0.01］ and internal rotation ［MD=-2.95, 95%CI (-4.57, -1.32), Z=3.56, P=0.0004］significantly increased in steroids injection group. Conclusion: Steroids injection can safely and effectively reduce the pain of HSP patients and promote the upper limb rehabilitation. |
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