推拿疗法治疗膝关节骨性关节炎随机对照试验的Meta分析

Meta Analysis of Randomized Controlled Trial of Massage Therapy for Knee Osteoarthritis

目的 探究推拿治疗膝关节骨性关节炎(KOA)的有效性和安全性。方法 从中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据知识服务平台、pubmed四个数据库中搜索,推拿治疗膝关节骨性关节炎与空白对照或者安慰性治疗对比的随机对照试验,检索时间从数据库建立到2019年12月1日。所有数据由两位作者独立评估和提取。Cochrane合作推荐的偏倚风险评估用于评估所选研究的质量。采用RevMan 5.3对推拿疗法的有效性和安全性进行荟萃分析。结果 6篇文献,359名参与者被最终被纳入。推拿疗法较空白对照及安慰性治疗可以改善特定距离内行走时间(MD=-1.60, 95%CI=-2.57~-0.63,P<0.05),然而并不能有效的缓解疼痛(SMD=-0.38, 95%CI=-1.35~0.19,P>0.05),单个研究表明推拿可以改善患者关节活动度(MD=8.21, 95%CI=-2.09~14.33,P<0.05)。结论 推拿疗法可能可以改善患者关节功能,然而由于纳入的研究较少以及现有的研究质量较低,推拿治疗膝关节骨性关节炎的疗效及安全性仍需要更多高质量、多中心、大样本的随机对照试验来证实。

Objective This study aimed to evaluate the efficacy and safety of message as a clinical treatment for knee osteoarthritis(KOA). Methods Randomized controlled trials(RCTs) of message therapy compared with blank control or sham treatment for KOA were identified in searches of four databases from their inception to December 2019. All data were assessed and extracted by two authors independently. The risk of bias assessment recommended by the Cochrane Collaboration was used to assess the quality of the selected studies. RevMan 5.3 was used to conduct Meta-analysis for the efficacy and safety of acupoint injection. Result six trials with 359 participants were eventually included. Massage therapy could significantly improve the walking time within specific distances(MD=-1.60, 95%CI=-2.57-0.63,P<0.05) compared with blank control or sham therapy, but it could not effectively relieve pain(SMD=-0.38,95%CI=-1.35-0.19,P>0.05). Single studies had shown that massage can improve joint mobility(MD=8.21, 95%CI=-2.09-14.33,P<0.05). Conclusion Massage therapy may improves the speed of walking and joint mobility in KOA patients. However, due to the number of existing studies is relatively small and the low quality of the literature, its efficacy and advantages needs more high-quality, multi-center, large-sample RCTs to verify.