手法治疗肩周炎临床报告的循证医学评价 - Journal of Integrative .PDF

中西医结 合学 报 2 004 年 5 月 第 2 卷 第 3 期 J Chin Integr Med , May 2 004 , Vol. 2 , N o. 3 ·185 · 手 法 治 疗 肩 周 炎 临床 报 告 的循 证 医 学 评 价 胡 军, 严隽陶 ( 上海 中医药大学附属岳阳中西医结合医院推拿科, 上海 200437) [ 摘要] 目的: 通过临床文献用循证医学理论评价手法治疗肩 周炎的疗效。方法: 检索几个主要文献 数据库, 得到近 5 年来 关于手法治疗肩周炎的文献 242 篇。用纳入标准鉴定后, 对其 中 10 篇文献进行循证医学评价 。结果: 手法单独应用 或/ 和其 他疗法联合应用对肩周炎有一定的疗效; 所评价的文献均为低质量 文献 。结论: 由于低质量的试验和潜在 的发表偏倚, 现有 证据不足 以推荐手法治疗取代其他疗法; 所评价文献的低质量说明手法治疗肩周 炎的临床试验存在一些应引起注意 的方法 学 问题 。 [ 关键词] 肩周炎; 手法疗法; 评价研究 [ 中图分类号] R274. 94 3 [ 文献标识码] A [ 文章编号] 1672 -1977 ( 2004) 0 3-0185-04 E va lu at ion of clin ical r ep or t s in tr eat in g p er iar thr it is of sh ou lder by m an ipu la t ion w ith th e th eor y of ev i- den ce-b a sed m edicin e HU Jun , YAN Jun -Tao ( Tuina Department , Yueyang Hospital of Integrated Traditional Chin ese and Western Medicin e, Shangh ai University of Traditional Chi- nese Medicine, Shanghai 200437 , Ch ina) AB STAR CT Obj ective : To exp lore the effect of treating periarthritis of should er with man ipu lation through evaluating clinical reports with the theor y of evidence-based medicine ( EMB ) . M eth od s: By retrieval of some main medical literatu re databases in the p ast 5 years, 242 articles on treating periarthritis of shoulder with manipulation were available . Selected b y admission stan dar d, 10 of them were evaluated with EBM theory. R esu lt s: Both single-application and un ion-application of manip ulation were effective to periarthritis of shoulder, but the evaluated ar ticles were all low-qu ality articles. Con clu sion : Becau se of low-qu ality clinic test an d larvaceous pub li- cation b ias, th e extan t eviden ce is not enough to recommen d replacing other th erapeutic m ethod s b y manipulation. Th e low quality of e- valuated articles su ggest s th at there exist some methodology problems in th e clinic test on treatin g p eriar thritis of