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姜黄素制剂或其与常规疗法联合与单纯常规疗法治疗膝骨关节炎的比较。

The comparison of curcuminoid formulations or its combination with conventional therapies versus conventional therapies alone for knee osteoarthritis.

机构信息

Xiyuan Hospital, China Academy of Chinese Medical Sciences, No. 1 Xiyuan Playground, Haidian District, Beijing, 100091, China.

出版信息

Clin Rheumatol. 2022 Jul;41(7):2153-2169. doi: 10.1007/s10067-022-06105-2. Epub 2022 Mar 16.

Abstract

BACKGROUND

Presently, curcuminoid formulations or its combination with conventional therapies has been used for the treatment of knee osteoarthritis (KOA). Nevertheless, evidence is limited due to small-sized clinical trials. This study aims to evaluate the efficacy of curcuminoid formulations or its combination with conventional therapies for KOA.

METHODS

Randomized controlled trials comparing curcuminoid formulations or its combination with conventional therapies versus conventional therapies, such as non-steroidal antiinflammatory drugs (NSAIDs) and chondroitin sulfate/glucosamine, were searched from databases.

RESULTS

In total, 14 studies involving 1533 patients were included. Curcuminoid formulations were comparative to NSAIDs in reducing Visual Analogue Scale (VAS), total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and WOMAC score for pain/stiffness/physical function. No significant difference was seen between the two groups in terms of patients' satisfaction index, patients' global assessment, reduction of several inflammatory factor, rate of drug compliance, and rescue medication. Notably, curcuminoid formulations combined with NSAIDs significantly reduced VAS and WOMAC/Knee injury and OA Outcome Score (KOOS) pain score more than NSAIDs did. In addition, the curcuminoid formulations were superior to chondroitin sulfate/glucosamine in reducing VAS, total WOMAC score, and WOMAC score for stiffness/difficulty in physical function, while no significant difference was seen in reducing WOMAC pain score and Karnofsky Performance Scale score.

CONCLUSIONS

Curcuminoid formulations may be considered a promising alternative for treating KOA. Key points • Curcuminoid formulations are comparative to NSAIDs for KOA. • Curcuminoid formulations are superior to chondroitin sulfate/glucosamine for KOA. • Curcuminoid formulations could provide additional benefits in alleviating pain and some adverse events caused by NSAIDs.

摘要

背景

目前,姜黄素制剂或其与常规疗法的联合应用已被用于治疗膝骨关节炎(KOA)。然而,由于临床试验规模较小,证据有限。本研究旨在评估姜黄素制剂或其与常规疗法联合治疗 KOA 的疗效。

方法

从数据库中检索比较姜黄素制剂或其与常规疗法(如非甾体抗炎药(NSAIDs)和硫酸软骨素/葡萄糖胺)联合与常规疗法治疗 KOA 的随机对照试验。

结果

共纳入 14 项涉及 1533 名患者的研究。姜黄素制剂在减轻视觉模拟量表(VAS)、Wester Ontario 和 McMaster 大学骨关节炎指数(WOMAC)总分以及 WOMAC 疼痛/僵硬/躯体功能评分方面与 NSAIDs 相当。两组患者满意度指数、患者总体评估、多项炎症因子的降低、药物依从率和解救药物的使用无显著差异。值得注意的是,与 NSAIDs 相比,姜黄素制剂联合 NSAIDs 可显著降低 VAS 和 WOMAC/膝关节损伤和骨关节炎结局评分(KOOS)疼痛评分。此外,姜黄素制剂在降低 VAS、WOMAC 总分和 WOMAC 僵硬/躯体功能困难评分方面优于硫酸软骨素/葡萄糖胺,而在降低 WOMAC 疼痛评分和 Karnofsky 表现量表评分方面无显著差异。

结论

姜黄素制剂可能被视为治疗 KOA 的一种有前途的替代方法。

关键点

• 姜黄素制剂在治疗 KOA 方面与 NSAIDs 相当。

• 姜黄素制剂在治疗 KOA 方面优于硫酸软骨素/葡萄糖胺。

• 姜黄素制剂可能在减轻疼痛和 NSAIDs 引起的一些不良反应方面提供额外益处。

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