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中药治疗骨关节炎的疗效评价:系统评价和荟萃分析。

Evaluation of the Therapeutic Effect of Traditional Chinese Medicine on Osteoarthritis: A Systematic Review and Meta-Analysis.

机构信息

Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang 712046, China.

Pharmaceutical Factory of Shaanxi University of Chinese Medicine, Xianyang, China.

出版信息

Pain Res Manag. 2020 Dec 14;2020:5712187. doi: 10.1155/2020/5712187. eCollection 2020.

Abstract

BACKGROUND

Osteoarthritis (OA) is a common degenerative disease of bone and joint characterized by the damage of articular cartilage and hypertonia, which often occurs in the middle-aged and elderly. Traditional Chinese medicine (TCM) therapy, including acupuncture (ACU), oral administration, and external use of traditional Chinese medicines (TCMs), can significantly improve the therapeutic effect on OA and reduce the occurrence of side effects. We provide a latest meta-analysis on the treatment of OA with TCM.

MATERIALS AND METHODS

In the electronic database, appropriate articles without language restrictions on keywords were selected until August 1, 2019. All trajectories are screened according to certain criteria. The quality of qualified research was also assessed. We have made a detailed record of the results of the measurement. Meta-analysis was carried out with Revman 5.3 software.

RESULTS

Forty-four articles involving 4014 patients (2012 cases in the experimental group and 2002 cases in the control group) with OA were selected. This article focuses on the study of the treatment of OA by using the general mode of TCM. The quality evaluation included in the study was evaluated independently according to the Cochrane intervention system evaluation manual. In this meta-analysis, 68.18% of the literature correctly described the conditions for the generation of random assignment sequences, only 6.82% of the literature correctly mentioned the hidden details of allocation, and all studies mentioned randomly assigned participants. Compared with Western medicine, the total effective rate (TER) of OA treatment in TCM was significantly increased and the recurrence rate (RR) was significantly decreased ( < 0.00001). In addition, the experimental group was also superior to the control group in terms of the indicators of joint activity function, inflammatory factor content, and various indicators affecting bone metabolism. It can be showed by the network analysis diagram that Aconiti Radix, Achyranthis Bidentatae Radix, and other TCMs can inhibit inflammatory stimulation and relieve the pain symptoms of patients with OA. ACU at Yinlingquan, Xiyan, and other acupoints can effectively improve the clinical symptoms of patients with OA.

CONCLUSION

TCM therapy in treatment of patients with OA could effectively restore joint function, enhance the TER, and reduce RR. However, the results of this study should be handled with care due to the limitations existing. Some rigorous randomized controlled trials (RCTs) are needed to confirm these findings.

摘要

背景

骨关节炎(OA)是一种常见的骨骼和关节退行性疾病,其特征为关节软骨损伤和张力过高,常发生于中老年人。中医药疗法,包括针刺(ACU)、口服和外用中药(TCMs),可显著改善 OA 的治疗效果,降低副作用的发生。我们提供了中医药治疗 OA 的最新荟萃分析。

材料与方法

在电子数据库中,按关键词检索,不限制语言,直到 2019 年 8 月 1 日为止,筛选出所有符合条件的文章。根据一定的标准筛选出所有的轨迹。也对合格研究的质量进行了评估。我们对测量结果进行了详细的记录。使用 Revman 5.3 软件进行荟萃分析。

结果

共纳入 44 篇文章,涉及 4014 例 OA 患者(实验组 2012 例,对照组 2002 例)。本文重点研究了中医药治疗 OA 的一般模式。研究中包含的质量评价是根据 Cochrane 干预系统评价手册独立进行的。在这项荟萃分析中,68.18%的文献正确描述了随机序列产生的条件,只有 6.82%的文献正确提到了分配的隐藏细节,所有研究都提到了随机分配的参与者。与西药相比,中医药治疗 OA 的总有效率(TER)显著提高,复发率(RR)显著降低(<0.00001)。此外,实验组在关节活动功能指标、炎症因子含量及影响骨代谢的各项指标方面也优于对照组。通过网络图可以看出,乌头、牛膝等中药能抑制炎症刺激,缓解 OA 患者的疼痛症状。阴陵泉、膝眼等穴位的 ACU 可有效改善 OA 患者的临床症状。

结论

中医药治疗 OA 可有效恢复关节功能,提高 TER,降低 RR。但是,由于存在的局限性,应该谨慎处理这些结果。需要一些严格的随机对照试验(RCTs)来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/414f/7752303/9ba35c8cd847/PRM2020-5712187.001.jpg

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