膳食补充剂治疗膝关节骨关节炎的疗效：一项系统评价和网状Meta分析
Efficacy of dietary supplements for treating knee osteoarthritis: a systematic review and network meta-analysis.
作者信息
Du Pupu, Ajia Asha, Xiang Zhi, Zheng Shang, Hu Chenming, Wang Pingxi
机构信息
Dazhou Central Hospital, Dazhou, Sichuan, China.
School of Medicine and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
出版信息
Front Nutr. 2025 Mar 7;12:1556133. doi: 10.3389/fnut.2025.1556133. eCollection 2025.
BACKGROUND
Knee osteoarthritis (KOA) stands as a prevalent clinical condition that frequently affects individuals. A growing body of research has highlighted the potential advantages of dietary supplements, including glucosamine and chondroitin, in the management of KOA.
PURPOSE
This study aims to ascertain the most efficacious dietary supplement for KOA, with a specific focus on reducing pain, alleviating stiffness, and enhancing joint function.
METHODS
We conducted an exhaustive search of multiple databases, including PubMed, Web of Science, Embase, and the Cochrane Library, from inception to May 2023. We specifically focused on randomized controlled trials (RCTs) comparing various dietary supplements with the placebo group within the context of KOA. Assessment of outcomes among these groups relied on the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), with weighted mean differences (WMDs) and associated 95% confidence intervals (CIs) computed. Network meta-analyses were employed to compare outcomes across different supplement groups in comparison with the placebo. The surface under the cumulative ranking curve (SUCRA) was utilized to rank these supplements.
RESULTS
Our comprehensive analysis included 22 studies with 2,777 participants in total. The outcomes from our network meta-analysis yielded the following key findings: To reduce the total WOMAC score, the top three interventions were E-OA-7, LParActin, and LcS. For reducing the WOMAC score of pain, the most effective interventions were Aflapin, NEM, and PFP. In addressing the reduction of the WOMAC score of stiffness, NEM, Aflapin, and MSM emerged as the optimal interventions. Finally, for diminishing the WOMAC score of physical function, the most effective interventions were E-OA-7, LParActin, and LcS.
CONCLUSION
In comparison to the placebo, NEM (for stiffness), Aflapin (for pain), and E-OA-07 (for knee function and WOMAC total score) were discerned as the most effective interventions for the treatment of KOA.
CLINICAL TRIAL REGISTRATION
背景
膝关节骨关节炎（KOA）是一种常见的临床病症，经常影响个体。越来越多的研究强调了膳食补充剂，包括氨基葡萄糖和软骨素，在KOA管理中的潜在优势。
目的
本研究旨在确定对KOA最有效的膳食补充剂，特别关注减轻疼痛、缓解僵硬和增强关节功能。
方法
我们对多个数据库进行了详尽搜索，包括PubMed、科学网、Embase和Cochrane图书馆，时间跨度从创建到2023年5月。我们特别关注在KOA背景下比较各种膳食补充剂与安慰剂组的随机对照试验（RCT）。这些组间结局的评估依赖于西安大略和麦克马斯特大学骨关节炎指数（WOMAC），计算加权平均差（WMDs）和相关的95%置信区间（CIs）。采用网络荟萃分析来比较不同补充剂组与安慰剂相比的结局。利用累积排序曲线下面积（SUCRA）对这些补充剂进行排序。
结果
我们的综合分析包括22项研究，共2777名参与者。我们网络荟萃分析的结果产生了以下主要发现：为降低WOMAC总分，前三项干预措施是E-OA-7、LParActin和LcS。为减轻疼痛的WOMAC评分，最有效的干预措施是Aflapin、NEM和PFP。在解决僵硬的WOMAC评分降低方面，NEM、Aflapin和MSM成为最佳干预措施。最后，为降低身体功能的WOMAC评分，最有效的干预措施是E-OA-7、LParActin和LcS。
结论
与安慰剂相比，NEM（用于僵硬）、Aflapin（用于疼痛）和E-OA-07（用于膝关节功能和WOMAC总分）被认为是治疗KOA最有效的干预措施。
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