中药、推拿及针灸并用治疗膝关节骨性关节炎

Therapeutic effect of Chinese herbs, massage and acupuncture for knee osteoarthritis

目的:分析中药、推拿及针灸治疗膝关节骨性关节炎的治疗机制、治疗方法和疗效。资料来源:检索Medline1986-01/2006-03与中医药治疗膝关节骨性关节炎相关的文章,检索词“kneeosteoarthritis,Chineseherbs,massage,acupuncture”,限定文章语言种类为英文。检索CNKI中国学术期刊全文数据库和中国优秀博硕士论文全文数据库2000-01/2006-03关于中药、推拿、针灸治疗膝关节骨性关节炎相关文章,限定文章语言种类为中文,检索词“膝,骨关节炎,中药,针灸,推拿”。资料选择:选取包括处理组和对照组的文献,筛除非随机研究,对剩余的文献开始查找全文。纳入标准:①随机对照研究。②实验或临床研究包含平行对照组。③处理组为中药、推拿、针灸治疗膝关节骨性关节炎组。排除标准:重复性研究。资料提炼:共收集到276篇关于中药、推拿、针灸治疗膝关节骨性关节炎的随机和非随机研究文章,23个实验或临床研究符合纳入标准。排除的253篇文章,231篇为未随机研究或重复性研究,22篇为综述类文章。资料综合:23个试验包括约440只实验动物和410例患者,证实了中药具有保护软骨功能,预防关节软骨退变;降低骨内压,改善微循环障碍;抑制氧自由基损伤,提高自由基清除剂超氧化物歧化酶的活性,抑制一氧化氮;抑制滑膜炎症,降低血清透明质酸,调节异常的细胞因子水平;调节性激素水平等作用,中药,推拿和针灸对膝关节骨性关节炎具有确切的治疗作用。结论:运用中药、推拿和针灸治疗膝关节骨性骨关节炎具有确切的效果。采用2种以上治法相结合可提高临床疗效。

OBJECTIVE： To analysis the mechanism, method and effect of Chinese herbs, massage and acupuncture for treating knee osteoarthritis. DATA SOURCES： We researched the Medline database in English from January 1986 to March 2006 and CNKI full text database as well as Chinese outstanding papers for doctors and masters in Chinese from January 2000 to March 2006 for related articles with the terms of “knee osteoarthritis, Chinese herbs, massage, acupuncture”. STUDY SELECTION： The articles including controls and treatment group were selected to look up the full texts, and the non-randomized studies were excluded. Inclusion criteria：①randomized controlled research. ②experimental or clinical study involving parallel control group. ③knee osteoarthritis group treated with Chinese herbs, massage and acupuncture. Exclusion criteria： Repetitive study. DATA EXTRACTION： Totally 276 randomized or non-randomized articles were collected on treatments of Chinese herbs, massage and acupuncture for knee osteoarthritis, and 23 experimental or clinical studies met the inclusion criteria. Among the 253 deleted articles, 231 ones were non-randomized studies or duplicated articles, and 22 ones were reviews. DATA SYNTHESIS： There were 440 experimental animals and 410 patients involved in 23 trials, which confirmed that Chinese herbs could protect cartilage function, prevent the degeneration of articular cartilage; reduce the intraosseous pressure, improve microcirculation of bone; inhibit oxygen-derivod free radical injury, increase the activity of superoxide dismutase （SOD）, and restrain nitrogen monoxide; inhibit synovitis, decrease serum hyaluronic acid （HA） and regulate the level of abnormal cell factor;, accommodate sex hormone, etc. Chinese herbs, massage and acupuncture were effective for treating knee osteoarthritis. CONCLUSION： It is evident that Chinese herbs, massage and acupuncture are effective for knee osteoarthfitis. Both or more combined therapy may enhance the clinical effects.