针刀联合关节腔内注射药物治疗膝骨关节炎临床疗效的Meta分析

Clinical outcomes of nedle-knife therapy combined with knee intra-articular injection of drugs for treatment of knee osteoarthritis:a meta-analysis

目的:系统评价针刀联合关节腔内注射药物治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法:应用计算机检索中国知网、维普网、万方数据库、中国生物医学文献服务系统、PubMed、Embase、Web of Science和Cochrane Library中关于针刀联合关节腔内注射药物治疗KOA的对比研究文献,检索时限均为建库至2022年10月31日。试验组采用传统针刀联合关节腔内注射药物治疗,对照组仅采用关节腔内注射药物治疗。依据文献检索及筛选方案筛选出符合要求的文献后,由2名研究人员分别独立进行数据提取和质量评价。采用Revman5.4软件进行Meta分析。结果:共检索到367篇文献,最终纳入11篇文献,共涉及1601例患者,其中试验组800例,对照组801例。Meta分析结果显示,试验组有效率、Lysholm膝关节评分高于对照组[RR=1.21,95%CI(1.16,1.25),P=0.000;MD=6.01,95%CI(3.82,8.20),P=0.000],膝关节疼痛视觉模拟量表评分、西安大略和麦克马斯特大学骨关节炎指数评分低于对照组[MD=-1.17,95%CI(-1.24,-1.09),P=0.000;MD=-6.94,95%CI(-8.31,-5.56),P=0.000]。结论:针刀联合关节腔内注射药物治疗KOA的临床疗效优于单纯关节腔内注射药物。

Objective:To systematically review the clinical outcomes of needleknife therapy combined with knee intraarticular injection of drugs for treatment of knee osteoarthritis(KOA).Methods:All controlled clinical trial articles about clinical outcomes of needleknife therapy combined with knee intraarticular injection of drugs for treatment of KOA included from database establishing to October 31,2022 were retrieved from the China National Knowledge Internet,Vip Database,Wanfang Database,Chinese Biomedical Literature Service System,PubMed,Embase,Web of Science and Cochrane Library through computer.The patients in experiment group were treated with conventional needleknife therapy combined with knee intraarticular injection of drugs,while the ones in control group merely with knee intraarticular injection of drugs.The articles were retrieved and screened and the information was extracted independently by two researchers according to the inclusion and exclusion criteria.The methodological quality of research in the articles was evaluated using bias risk assessment tools recommended by Cochrane handbook independently by the same two researchers,and if any disagreement was found between them,discussion was conducted or another researcher was invited for making a final decision,and then a Metaanalysis was conducted by using Revman5.4 software.Results:Three hundred and sixtyseven articles were searched out.After screening,11 articles(1601 patients)were included in the final analysis,800 patients in experiment group and 801 ones in control group.The results of Metaanalysis revealed that the clinical effective rate and Lysholm knee score were higher,while the knee pain visual analogue scale(VAS)score and Western Ontario and McMaster Universities osteoarthritis index(WOMAC)score were lower in experiment group compared to control group(RR=1.21,95%CI(1.16,1.25),P=0.000;MD=6.01,95%CI(3.82,8.20),P=0.000;MD=-1.17,95%CI(-1.24,-1.09),P=0.000;MD=-6.94,95%CI(-8.31,-5.56),P=0.000).Conclusion:The needleknife therapy combined with knee intraarticular injection of drugs has better clinical outcomes compared to knee intraarticular injection of drugs alone in treatment of KOA.