肌内效贴治疗肱骨外上髁炎临床疗效的Meta分析-现代医学

肌内效贴治疗肱骨外上髁炎临床疗效的Meta分析

作者：王浩杰¹ 张博宇¹ 骆鹏任¹ 刘翀¹ 魏佳铭² 李翔宇³ 朱立国⁴ 金哲峰¹

单位：1. 中国中医科学院望京医院运动医学三科, 北京 100102;
2. 中国中医科学院望京医院脊柱二科, 北京 100102;
3. 中国中医科学院医学实验中心, 北京 100700;
4. 中国中医科学院望京医院中医正骨技术北京市重点实验室, 北京 100102

关键词：肱骨外上髁炎网球肘肌内效贴 Meta分析临床疗效

分类号：R274

出版年·卷·期（页码）：2026·45·第四期（634-646）

摘要：

目的： 通过系统评价方法探讨肌内效贴(KT)治疗肱骨外上髁炎的临床疗效。方法： 检索中国知网、万方数据、维普资讯、中国生物医学文献数据库(CBM)等中文数据库，以及PubMed、Embase、Cochrane对照试验中心注册库、Web of Science、Springer Link等英文数据库，查找KT治疗网球肘的随机对照试验(RCT)，检索时限均为建库至2025年7月。采用RevMan 5.4对纳入文献进行方法学质量评价、数据整合定量分析和敏感性分析，用Stata 16.0统计软件进行发表偏倚评估。结果： 最终纳入13项RCT，共包含679例肱骨外上髁炎患者，其中KT干预的试验组340例，对照组339例。Meta分析结果显示：(1) XYI型(SMD=-1.57,95%CI -1.93～-1.22，Z=8.79，P<0.001)、其他型(SMD=-1.08，95%CI -1.36～-0.81，Z=7.65，P<0.001)两种贴扎方式均可有效缓解疼痛，双Y型(SMD=-1.10，95%CI -2.39～ 0.19，Z=1.67，P=0.09)及XY型(SMD=-0.31，95%CI -0.64～0.02，Z=1.85，P=0.06)对于疼痛的缓解无显著改善，且双Y型敏感性分析显示结果不稳健；在中高收入国家(SMD=-1.00，95%CI -1.40～-0.59，Z=4.83，P<0.001)与中低收入国家(SMD=-1.26，95%CI -1.83～-0.70，Z=4.40，P<0.001)KT均可缓解疼痛。(2) 试验组与对照组相比，最大握力(SMD=0.75，95%CI 0.31～1.19，Z=3.32，P=0.000 9)及无痛握力(SMD=0.54，95%CI 0.18～0.91，Z=2.93，P=0.003)均升高，但无痛握力这一指标稳定性不足。(3) 对于臂、肩、手功能障碍(DASH)评分，试验组相较于对照组改善更为显著(SMD=-2.13，95%CI -3.92～-0.34，Z=2.34，P=0.02)。(4) 网球肘评估量表(PRTEE)评分经分析，结果不稳健。结论： KT治疗网球肘具有良好的临床疗效，但受亚组研究少、异质性高及原始研究局限性影响，证据强度有待提升，未来应通过标准化干预方案、统一疗效评价体系，开展大规模多中心双盲RCT以增加论证强度。

Objective: To investigate the clinical efficacy of kinesio taping(KT) for lateral epicondylitis through systematic review methods. Methods: Multiple Chinese databases including CNKI, Wanfang, VIP database, and China Biology Medicine database(CBM), as well as international databases including PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and SpringerLink were systematically searched to identify randomized controlled trials(RCTs) of KT for tennis elbow, with the search time limit from database inception to July 2025. Methodological quality assessment, quantitative data synthesis, and sensitivity analysis were conducted using Review Manager 5.4, while publication bias assessment was performed using Stata 16.0 statistical software. Results: A total of 13 RCTs involving 679 patients with lateral epicondylitis were finally enrolled, with 340 patients assigned to the experimental group receiving KT intervention and 339 to the control group. Meta-analysis results showed that:(1) both XYI-type(SMD=-1.57, 95% CI-1.93- -1.22, Z=8.79,P<0.001) and other-type(SMD=-1.08, 95% CI -1.36- -0.81, Z =7.65,P<0.001) taping methods significantly relieved pain, whereas double-Y type(SMD=-1.10, 95%CI -2.39-0.19, Z=1.67, P=0.09) and XY-type(SMD=-0.31, 95%CI -0.64-0.02, Z=1.85, P=0.06) showed no significant improvement in pain relief; moreover, sensitivity analysis suggested that the result of the double-Y type was not robust and should be interpreted with caution; additionally, KT significantly relieved pain in both upper-middle-income countries(SMD=-1.00, 95%CI-1.40- -0.59, Z=4.83,P<0.001) and lower-middle-income countries(SMD=-1.26, 95%CI -1.83- -0.70), Z=4.40,P<0.001);(2) compared with the control group, both maximum grip strength(SMD=0.75，95%CI (0.31-1.19，Z=3.32,P=0.000 9) and pain-free grip strength(SMD=0.54, 95%CI 0.18-0.91, Z=2.93,P=0.003) were significantly increased; however, the stability of the pain-free grip strength result was insufficient;(3) the disabilites of the arm, shoulder, and hand(DASH) score was significantly improved in the experimental group compared with the control group(SMD=-2.13, 95%CI -3.92- -0.34, Z=2.34, P=0.02);(4) For the patient-rated tennis elbow evaluation(PRTEE) score, the analysis indicated that the results were not robust. Conclusion: KT demonstrates favorable clinical efficacy for tennis elbow; however, the strength of evidence remains limited due to the scarcity of subgroup studies, high heterogeneity, and limitations inherent in the original studies. Future research should enhance methodological rigor by standardizing intervention protocols, unifying efficacy evaluation systems, and conducting large-scale, multicenter, double-blind RCTs.

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