针刺治疗膝骨关节炎的循证医学进展与展望

Evidence-based medical progress and prospects of acupuncture treatment for knee osteoarthritis

随着人口老龄化现象加重,膝骨关节炎(KOA)作为一种退行性疾患在临床实践中的诊疗比例呈现上升趋势。针刺作为KOA的常用治疗手段之一,其疗效在国内外备受关注。文章从新的视角,筛选并解读高质量针刺随机对照试验、Meta分析,并对比不同版本指南推荐情况,以论述针刺治疗KOA的循证医学进展。结果发现多数高质量研究证实针刺疗效,国际指南正逐步认可针刺疗法。进一步论述针刺治疗KOA在重度人群的应用、与运动疗法的疗效差异、针刺剂量的选择3个方面的研究潜力和重要性,以期为未来研究提供方向。

With the increasing prevalence of population aging,the diagnosis and treatment of knee osteoarthritis(KOA),a degenerative disease,is becoming more common in clinical practice.Acupuncture,as one of the common treatment methods for KOA,has garnered considerable attention both domestically and internationally for its efficacy.This review,from a new perspective,selects and interprets high-quality acupuncture randomized controlled trials and Meta-analyses,and compares the recommendations of different versions of guidelines to discuss the evidence-based medical progress of acupuncture treatment for KOA.The results indicate that most high-quality studies confirm the efficacy of acupuncture,and international guidelines are gradually recognizing acupuncture therapy.Further discussion is provided on the potentiality and importance of research in three aspects:the application of acupuncture in severe cases,the efficacy differences between acupuncture and exercise therapy,and the selection of acupuncture dosage,aiming to provide direction for future research.