中西医结合治疗膝关节骨性关节炎的Meta分析

Meta-analysis on the treatment of knee osteoarthritis by integration of traditional Chinese medicine and Western medicine

目的:对中西医结合治疗膝关节骨性关节炎的有效性作出较客观的评估。方法:以"膝关节骨性关节炎""膝关节退行性变""膝关节退行性病""老年性膝关节病"等为检索词从中国生物医学文献数据库、维普资源系统、中国期刊网检索已发表文章,以中西医结合治疗膝关节骨性关节炎的随机对照试验为研究对象,采用RevMan5.0软件进行统计分析,采用优势比作为效应合并指标。结果:共9篇文献符合纳入标准,所有试验质量均不高,未发现双盲试验。分析显示,与常规西医治疗相比,中西医结合治疗膝关节骨性关节炎对总显效率的影响差异有统计学意义(OR=3.21,95%CI:2.33～4.41)。漏斗图显示基本对称,提示纳入文献的发表性偏倚控制尚可。结论:以本项Meta分析为基础,中西医结合治疗膝关节骨性关节炎较单纯西医治疗有益。但由于纳入试验的质量不高,目前尚不能得出最终结论。

Objective：To evaluate objectively the effectiveness of integration of traditional Chinese medicine and Western medicine（TCM WM THERAPY） on treatment of knee osteoarthritis.Methods：Published literatures were retrieved from Chinese BioMedical Literature Database,Vip Resources Systems,Net of Chinese Journal,＂knee osteoarthritis＂,＂knee joint degeneration＂,＂knee joint degeneration disease＂and＂senile knee joint disease＂as index terms.Randomized controlled trial on treatment of knee osteoarthritis by TCM WM THERAPY was taken as object of study,statistical analysis was carried on through Rev-Man5.0 software,and odds ratio（OR） was chosen as the index of combined effects.Results：9 literatures in total met the inclusion criteria.All of the trials were not of high quality generally,and none of them was double-blinded trial.Analysis showed that the treatment of knee osteoarthritis by TCM WM THERAPY had statistical difference on the total effective rate compared with conventional Western medicine treatment（OR=3.21,95%CI：2.33～4.41）.Funnel plot was symmetrical in general,and it prompted that publication bias for the literatures was controlled passably.Conclusion：The results of this Meta-analysis show that effect of TCM WM THERAPY is better than that of conventional Western medicine on knee osteoarthritis.But we can not make a final conclusion due to low quality of inclusion trials.