摘要
目的:系统性总结现有针灸治疗肩周炎的系统评价证据,并调查临床专家对针灸治疗该病的关注点和需求,揭示系统评价证据与临床关注问题之间的差异。方法:计算机检索建库至2022年12月31日中国期刊全文数据库(CNKI)、中国生物医学文献数据库(Sino Med)、维普资讯中文期刊服务平台(VIP)、万方数据知识服务平台(Wanfang)、Pub Med、EMbase和Cochrane Library数据库中针灸治疗肩周炎的系统评价和Meta分析,由2名研究者独立筛选文献、提取资料,应用AMSTAR-2对纳入研究的方法学质量进行评价。基于系统评价及专家讨论制定针灸治疗肩周炎临床关注问题调查问卷并向临床医生发放,从人群、干预措施、对照措施、结局指标及评价时点5个维度比较系统评价证据与临床关注问题的差异。结果:现有系统评价证据与临床关注问题存在差异,现有研究存在未充分考虑不同证型、病程阶段的个性化治疗需求,结局指标应用不当,结局测量时点模糊,对照组设置不规范及研究方法学质量低等问题。结论:建议未来的研究提高方法学质量、关注不同患者群体、优化结局指标、规范对照组设置,以更好地满足患者需求,实现证据与临床医生需求的最佳匹配。
Objective To reveal the gap between the evidence of systematic reviews(SRs)and clinical concerns by systematically summarizing the evidence on acupuncture and moxibustion for frozen shoulder and investigating the concerns and needs of clinicians in treatment with acupuncture and moxibustion for this disease.Methods The articles of SR and Meta-analysis on acupuncture and moxibustion for frozen shoulder were searched from CNKI,Wanfang,VIP,SinoMed,PubMed,EMbase and Cochrane Library,starting from the inception of each database up to December 31st,2022.Two researchers screened the articles and extracted data independently.Using AMSTAR-2,the methodological quality of the included studies was evaluated.Based on systematic reviews and expert discussion,a questionnaire on clinical concerns of acupuncture and moxibustion for frozen shoulder was developed and distributed to clinicians.The discrepancies between the evidence and clinical concerns were compared from 5 dimensions,including population,interventions,control measures,outcome indicators and review time points.Results The evidence gaps existed between SRs and clinical concerns.In the existing studies,the needs of personalized treatment were not fully considered in terms of different syndromes/patterns of frozen shoulder and stages of illness,the outcome indicators were not employed properly,the time for outcome measurement was vague,the control groups were set up outside of standardization,and the methodological quality was lower.Conclusion It is suggested that future studies should improve the quality of methodology,lay more consideration to different patient groups,optimize outcome indicators and standardize the setting of control groups,so as to better meet the needs of patients and achieve the best match between evidence and clinicians'needs.
作者
罗臻
岗卫娟
胡晓艺
陈欢
王璐
修文萃
明恬妤
景向红
LUO Zhen;GANG Weijuan;HU Xiaoyi;CHEN Huan;WANG Lu;XIU Wencui;MING Tianyu;JING Xianghong(Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《中国针灸》
北大核心
2025年第11期1673-1680,共8页
Chinese Acupuncture & Moxibustion
基金
中国中医科学院科技创新工程项目:CI2021A03503
中央级公益性科研院所基本科研业务费专项资金资助项目:ZZ20211810。
关键词
肩周炎
针灸
证据差异
临床关注问题
frozen shoulder
acupuncture and moxibustion
evidence gap
clinical concerns
