超声引导下注射肉毒杆菌毒素治疗局部疼痛疗效的Meta分析

doi:10.3877/cma.j.issn.1674-6880.2021.06.009

中华危重症医学杂志(电子版) ›› 2021, Vol. 14 ›› Issue (06) : 484 -488. doi: 10.3877/cma.j.issn.1674-6880.2021.06.009

荟萃分析

超声引导下注射肉毒杆菌毒素治疗局部疼痛疗效的Meta分析

何建娣¹, 田果², 殷珊娱¹, 胡瑛², 钟丽云¹, 蒋天安², 赵齐羽¹^,^†(

)

^1. 310003　杭州，浙江大学医学院附属第一医院超声医学科
^2. 310003　杭州，浙江大学医学院附属第一医院超声医学科；浙江省脉冲电场技术医学转化重点实验室

收稿日期:2021-01-28 出版日期:2021-12-31
通信作者: 赵齐羽
基金资助:
国家自然科学基金面上项目(81971623); 浙江省数理医学学会联合基金项目(LSY19H180015); 浙江省自然科学基金重点项目(LZ20H180001)

Efficacy of botulinum toxin injection for regional pain by ultrasonography: a meta-analysis

Jiandi He¹, Guo Tian², Shanyu Yin¹, Ying Hu², Liyun Zhong¹, Tianan Jiang², Qiyu Zhao¹^,^†()

^1. Department of Ultrasound Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
^2. Department of Ultrasound Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; Zhejiang Provincial Key Laboratory of Pulsed Electric Field Technology Medical Transformation, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China

Received:2021-01-28 Published:2021-12-31
Corresponding author: Qiyu Zhao

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引用本文：

何建娣, 田果, 殷珊娱, 胡瑛, 钟丽云, 蒋天安, 赵齐羽. 超声引导下注射肉毒杆菌毒素治疗局部疼痛疗效的Meta分析[J/OL]. 中华危重症医学杂志(电子版), 2021, 14(06): 484-488.

Jiandi He, Guo Tian, Shanyu Yin, Ying Hu, Liyun Zhong, Tianan Jiang, Qiyu Zhao. Efficacy of botulinum toxin injection for regional pain by ultrasonography: a meta-analysis[J/OL]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2021, 14(06): 484-488.

目的

系统评估超声引导下注射肉毒杆菌毒素（BoNT）对局部疼痛（神经疼痛和关节痛等）患者疗效的影响。

方法

计算机检索Pubmed、Embase、Web of Science、Scopus、中国知网、维普及万方数据库从建库至2020年2月发表的关于超声引导下注射BoNT治疗局部疼痛患者的文献。由2位研究者按照纳入和排除标准对相关文献独立进行文献筛选及数据提取，使用STATA 12.0软件进行Meta分析。

结果

共纳入7篇文献，包含115例患者。Meta分析结果显示，与治疗前比较，局部疼痛患者在超声引导下注射BoNT治疗后1个月[加权平均差（WMD） = 3.68，95%置信区间（CI）（2.37，5.00），Z = 5.50，P < 0.001]、3个月[WMD = 4.09，95%CI（1.85，6.34），Z = 3.58，P < 0.001]及6个月[WMD = 5.29，95%CI（3.27，7.30），Z = 5.15，P < 0.001]视觉模拟量表评分均显著降低。

结论

超声引导下注射BoNT可以有效缓解患者的神经性疼痛和关节疼痛。

关键词: 超声检查, 肉毒毒素类, 关节痛, 神经痛, Meta分析

Objective

To systemically evaluate the effect of botulinum toxin (BoNT) injection for regional pain (neuropathic and joint pain) by ultrasonography.

Methods

The articles about BoNT injection for patients with regional pain by ultrasonography were searched in Pubmed, Embase, Web of Science, Scopus, CNKI, VIP and Wanfang databases published up to February 2020. Two reviewers independently screened articles and extracted data according to inclusion and exclusion criteria. The STATA 12.0 software was used to perform meta-analysis.

Results

A total of seven studies with 115 patients were included. Meta-analysis demonstrated that the visual analogue scale scores at one month [weighted mean difference (WMD) = 3.68, 95% confidence interval (CI) (2.37, 5.00), Z = 5.50, P < 0.001], there months [WMD = 4.09, 95%CI (1.85, 6.34), Z = 3.58, P < 0.001] and six months [WMD = 5.29, 95%CI (3.27, 7.30), Z = 5.15, P < 0.001] after BoNT injection by ultrasonography were much lower than those before the treatment in patients with regional pain.

Conclusion

The BoNT injection by ultrasonography can effectively relieve patients' neuropathic and joint pain.

Key words: Ultrasonography, Botulinum toxins, Arthralgia, Neuralgia, Meta-analysis

表1 纳入研究的基本情况

纳入研究	研究类型	样本量（例）	年龄（岁，均数或 ± s）	疼痛原因	描述指标	NOS评分（分）
Abbasian等^[9]	前瞻性研究	15	47.3 ± 6.1	慢性足底筋膜炎	①②③	6
Wu等^[10]	回顾性研究	18	61.4 ± 13.0	偏瘫肩痛	①②	6
Galván Ruiz等^[11]	回顾性研究	24	46.8 ± 9	肱骨外上髁炎	①②③	6
Artusi等^[12]	前瞻性研究	15	-	比萨综合征	①	6
Rodríguez-Pinero等^[13]	前瞻性研究	6	57	梨状肌综合征	①③	5
Al-Al-Shaikh等^[14]	回顾性研究	12	46.5	梨状肌综合征	③	5
Huang等^[15]	前瞻性研究	25	54.4 ± 9.6	慢性足底筋膜炎	①②	6

表1 纳入研究的基本情况

纳入研究	研究类型	样本量（例）	年龄（岁，均数或 ± s）	疼痛原因	描述指标	NOS评分（分）
Abbasian等^[9]	前瞻性研究	15	47.3 ± 6.1	慢性足底筋膜炎	①②③	6
Wu等^[10]	回顾性研究	18	61.4 ± 13.0	偏瘫肩痛	①②	6
Galván Ruiz等^[11]	回顾性研究	24	46.8 ± 9	肱骨外上髁炎	①②③	6
Artusi等^[12]	前瞻性研究	15	-	比萨综合征	①	6
Rodríguez-Pinero等^[13]	前瞻性研究	6	57	梨状肌综合征	①③	5
Al-Al-Shaikh等^[14]	回顾性研究	12	46.5	梨状肌综合征	③	5
Huang等^[15]	前瞻性研究	25	54.4 ± 9.6	慢性足底筋膜炎	①②	6

图1 超声引导下注射BoNT治疗前与治疗后1个月VAS评分比较的森林图注：BoNT.肉毒杆菌毒素；VAS.视觉模拟量表；WMD.加权平均差；CI.置信区间

图2 超声引导下注射BoNT治疗前与治疗后3个月VAS评分比较的森林图注：BoNT.肉毒杆菌毒素；VAS.视觉模拟量表；WMD.加权平均差；CI.置信区间

图3 超声引导下注射BoNT治疗前与治疗后6个月VAS评分比较的森林图注：BoNT.肉毒杆菌毒素；VAS.视觉模拟量表；WMD.加权平均差；CI.置信区间

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