手法治疗对女性乳腺癌幸存者慢性肌肉骨骼疼痛的治疗作用：一项系统评价与荟萃分析
Manual Therapy as Treatment for Chronic Musculoskeletal Pain in Female Breast Cancer Survivors: A Systematic Review and Meta-Analysis.
作者信息
Pinheiro da Silva Fabiana, Moreira Géssica Maria, Zomkowski Kamilla, Amaral de Noronha Marcos, Flores Sperandio Fabiana
机构信息
Physiotherapy Department, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil.
Physiotherapy Department, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil.
出版信息
J Manipulative Physiol Ther. 2019 Sep;42(7):503-513. doi: 10.1016/j.jmpt.2018.12.007.
OBJECTIVE
The purpose of this systematic review was to investigate the effectiveness of manual therapy (MT) for chronic musculoskeletal pain (CMP) in the upper limbs and thorax of female breast cancer survivors and to investigate the changes in the quality of life and function of these patients.
METHODS
Systematic searches were performed in the databases MEDLINE/PubMed, Cumulative Index of Nursing and Allied Health/EBSCO, Web of Science, and Physiotherapy Evidence Database, through March 2018, to identify randomized controlled trials investigating whether MT was effective to treat CMP pain in female breast cancer survivors (PROSPERO number CDR42017074175).
RESULTS
The database searches retrieved 1562 titles, and after screening, 5 papers were included for full analysis. The manual therapy techniques described in the included studies involved myofascial induction, myofascial release, classic massage, ischemic compression of trigger points, and myofascial therapy. A meta-analysis, using a fixed-effects model, found that MT decreased CMP intensity (standardized mean difference: 0.32; 95% CI 0.06-0.57), but no significant difference was observed in quality of life after the MT intervention in comparison with a control condition (standardized mean difference: 0.14; 95% CI 0.17-0.46).
CONCLUSION
Current evidence suggests that MT is considered effective for treating CMP in the upper limbs and thorax of female breast cancer survivors.
目的
本系统评价旨在探讨手法治疗（MT）对女性乳腺癌幸存者上肢和胸部慢性肌肉骨骼疼痛（CMP）的有效性，并研究这些患者生活质量和功能的变化。
方法
截至2018年3月，在MEDLINE/PubMed、护理及联合健康累积索引/EBSCO、科学引文索引和物理治疗证据数据库中进行系统检索，以识别调查MT对女性乳腺癌幸存者CMP疼痛治疗是否有效的随机对照试验（PROSPERO编号CDR42017074175）。
结果
数据库检索共获得1562篇文献标题，经筛选后，纳入5篇文献进行全面分析。纳入研究中描述的手法治疗技术包括肌筋膜诱导、肌筋膜松解、经典按摩、触发点缺血性按压和肌筋膜治疗。采用固定效应模型进行的荟萃分析发现，MT降低了CMP强度（标准化均数差：0.32；95%可信区间0.06 - 0.57），但与对照条件相比，MT干预后生活质量无显著差异（标准化均数差：0.14；95%可信区间0.17 - 0.46）。
结论
目前的证据表明，MT被认为对治疗女性乳腺癌幸存者上肢和胸部的CMP有效。
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