A Network Meta-analysis Of The Treatment Of Radial Styloid Process Stenosing Tenosynovitis By The Single External Therapy Of Traditional Chinese And Western Medicine

Purpose:This study uses the statistical method of reticular Meta-analysis to systematically evaluate the efficacy and safety of external treatment of traditional Chinese and western medicine in the treatment of stenosing tenosynovitis of the radial styloid process and to provide evidence-based medical evidence for further clinical application.Materials and methods:The full-text databases of Chinese periodicals,Weipu Chinese sci-tech Periodicals Database,Wanfang Database,Chinese Biomedical Literature Database,Pubmed,Cochrane Library,Embase and other 7 databases were searched by computer.The related literatures of acupuncture,needle knife,fire needle,electroacupuncture,floating needle,warm needle,massage,blocking and shock wave were published in the seven databases for the treatment of styloid stenosing tenosynovitis(Randomized controlled trial).The search period is between construction and December 2020.Literature screening,data extraction and bias risk assessment were performed independently and cross-checked by two researchers.The main outcome measures were efficiency,safety and adverse reactions.The literature was evaluated for quality using the bias risk assessment approach recommended in the Cochrane systematic review manual.The data were analyzed by revman 5.2 and STATA15.1 software,and the direct and indirect comparison was made.The Odds ratio(OR),Mean difference(MD)and 95%Confidence interval(CI)were calculated for the binary and continuous variables respectively.The network Meta-analysis was carried out by drawing network relation graph,inconsistency test graph,area probability sorting graph and funnel graph under the curve.Results:A total of 24 articles,23 articles in Chinese and 1 article in English,involving 1733 patients,were included.Effective Meta-analysis showed that needle-knife VS closure,acupuncture VS massage,closure VS external medication had statistical significance.According to the effective rate of SUCRA,acupuncture,shock wave and acupotomy have better curative effect.The network diagram shows that the most frequent studies included in the Randomized controlled trial were the efficient blocking and needle knife controlled trials.There were 17 ADR cases reported in three articles,including 15 cases after block therapy,1 case after shock wave therapy and 1 case after topical medication.For the study of acupuncture therapy included in the literature,the main points of the hand-taiyin and hand-yangming meridians are selected,the main points of Yangxi,the matching points are hand-sanli,lack of row,etc,once a day,6 times altogether,the therapeutic effect is better.The treatment frequency was 13 Hz,the number of shock wave was 2000,the treatment pressure was 1 bar,the treatment time was 1 week,the treatment time was 3 times,the therapeutic effect was better.In acupotomology,the tenderness point is selected as the entry point for tendon stripping and loosening,and the therapeutic effect is better after one treatment.Conclusion:1.According to the effective rate of SUCRA,acupuncture,shock wave and acupotomy have better curative effect2.Acupuncture,acupotomy,massage and other traditional Chinese medical treatments have high safety and few adverse reactions3.The best recommended acupuncture therapy for the treatment of stenosing tenosynovitis of styloid process of radius is Yangxi,Hand Sanli and column deficiency.