膝骨关节炎10年治疗概况:缺乏公认的评价标准及治疗方案

Overview of the treatment for knee osteoarthritis in 10 years: Lack of acknowledged evaluation criterion and therapeutic scheme

背景:近10年来有关治疗膝骨性关节炎的临床报道很多,但没有最佳治疗方案,且疗效也不够稳定。目的:通过对2000年以来膝骨关节炎临床治疗的分析,寻求治疗膝骨关节炎效果最好且疗效稳定的最佳方案。方法:以"膝骨关节炎,治疗,中医,组织工程"为检索词,应用计算机检索重庆维普(VIP)期刊全文数据库2000-01/2009-09有关文章,限定文章语言种类为中文。纳入有关膝骨性关节炎的临床治疗的文献,排除重复性研究和不典型报道,保留34篇文献做进一步分析。结果与结论:组织工程治疗膝骨关节炎主要集中在两个方面:①提高软骨的自我修复能力,诱导软骨的自然愈合。②利用与关节软骨相同或相似的组织或材料充填软骨。综合疗法治疗膝骨关节炎效果优于单一疗法,且疗效较稳定,尤其是中西医结合疗法,但是对其诊断分型及临床疗效的评价没有统一的标准。因此制定一个统一的评判标准,将有利于临床准确诊断分型及临床疗效的评估和疗法的选择,从而选择出最佳治疗方案,以提高疗效和稳定性。

BACKGROUND： Plenty of reports concerning knee osteoarthritis treatment in past 10 years, whereas, there is not an optimal therapeutic scheme, and the therapeutic effects remain unstable. OBJECTIVE： To seek an optimal therapeutic scheme with stable effects on knee osteoarthritis through the analysis of clinical treatments from the year of 2000. METHODS： Using computer technology to retrieve the articles in VIP periodical full-text data base on clinical treatment of knee osteoarthritis from January 2000 to September 2009. The search words were ＂knee osteoarthritis, therapy, treatment, method of therapy, method of treatment, therapeutic effect＂. The language was limited for Chinese. The clinical therapy on knee osteoarthritis was included. And the reproductive research or non-typical report was excluded. A total of 34 literatures were included for further analysis. RESULTS AND CONCLUSION： Tissue engineering for knee osteoarthritis mainly focus on two aspects： ①inducing natural healing by elevating self-repairing capability of cartilage. ②filling the cartilages with cartilage-like tissues or materials. The combined modality therapy exhibits superior therapeutic effects to single therapy, especially the treatment of integration of traditional Chinese and western medicine. However, there has not unified standard on diagnostic classification and evaluation of clinical therapeutic effects. Therefore, the unified standard for evaluation would be benefit to the accurate judgment of clinical diagnostic classification, the evaluation of therapeutic effect and the choice of treatment, in addition, it can promote the effectiveness and stability of treatments.