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[中医外治法联合关节腔注射透明质酸钠治疗膝关节骨关节炎的Meta分析]

[External therapies of traditional Chinese medicine combined with sodium hyaluronate injected in articular cavity therapy on knee osteoarthritis: Meta-analysis].

作者信息

Xu Yang-Kai, Zhu Fu-Gui, Feng Er-You, Fan Chao-Ling, Yu Guang-Shu, Wei Yan-Zhen, Xie Li-Hua

机构信息

Bone Surgery Area, The Second Affiliated Hospital of Xiamen University, Fuzhou 350007, China.

Institute of Medicine, Fujian Institute of Traditional Chinese Medicine, Fuzhou 350003, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2018 May;43(9):1934-1939. doi: 10.19540/j.cnki.cjcmm.20180307.021.

Abstract

To systematically evaluate the efficacy and safety of external therapies of traditional Chinese medicine(TCM) combined with sodium hyaluronate(SH) injected in articular cavity therapy on knee osteoarthritis(KOA). The following databases such as CNKI, WanFang, VIP, CBM, PubMed and Medline were researched to collect the randomized controlled trails on external therapies of TCM combined with sodium hyaluronate injected in articular cavity therapy on KOA. The selection of studies, assessment of methodological quality and data extraction were performed independently by two researchers. The methodological quality was assessed by using the Cochrane system evaluation methodology and Meta-analysis were performed by using Cochrane Collaboration's the RevMan 5.3 software. Forteen studies involving 1 449 patients were included. All of the trails were not adequate enough in methodological quality. Meta-analysis indicated that compared with control group, external therapies of TCM combined with sodium hyaluronate injected in articular cavity could raise effectiv rate(<0.000 01) and cure-rate(<0.000 01), improve Lysholm score(=0.003) and reduce VAS score(<0.000 1). But two groups have no difference in Womac score (=0.13).Compared with the treatment with sodium hyaluronate injected in articular cavity, external therapies of TCM combined with sodium hyaluronate injected in articular cavity, a promising treatment options, can be complementary advantages, improve the clinical curativ effect. But it still needs low risk and high quality clinical trials to verify.

摘要

系统评价中医外治法联合关节腔注射透明质酸钠治疗膝关节骨性关节炎(KOA)的疗效及安全性。检索中国知网、万方、维普、中国生物医学文献数据库、PubMed及Medline等数据库,收集中医外治法联合关节腔注射透明质酸钠治疗KOA的随机对照试验。由两名研究者独立进行文献筛选、方法学质量评价及数据提取。采用Cochrane系统评价方法评价方法学质量,应用Cochrane协作网的RevMan 5.3软件进行Meta分析。共纳入14项研究,涉及1449例患者。所有试验的方法学质量均欠佳。Meta分析结果显示,与对照组比较,中医外治法联合关节腔注射透明质酸钠可提高有效率(<0.000 01)和治愈率(<0.000 01),改善Lysholm评分(=0.003),降低视觉模拟评分法(VAS)评分(<0.000 1),但两组Womac评分差异无统计学意义(=0.13)。与单纯关节腔注射透明质酸钠治疗比较,中医外治法联合关节腔注射透明质酸钠是一种有前景的治疗选择,可优势互补,提高临床疗效,但仍需低风险、高质量的临床试验验证。

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