针刀与关节腔注射玻璃酸钠治疗膝骨关节炎疗效比较的系统评价和Meta分析

Acupotomoy versus intra-articular sodium hyaluronate for knee osteoarthritis: a systematic review and meta-analysis

目的:评价针刀治疗膝骨关节炎的有效性和安全性。方法:计算机检索中国知网(CNKI)、维普数据库(VIP)、万方数据库(Wanfang Data)、PubMed和Cochrane临床对照试验中心注册库(2011年第3期),所有数据库检索时间从建库到2011年9月15日。纳入治疗组采用针刀疗法、对照组采用关节腔注射玻璃酸钠的随机对照试验,由2名评价者独立提取资料和评价文献质量后采用RevMan 5.1软件进行Meta分析。结果:共纳入6个随机对照试验,涉及429例患者。Meta分析结果显示针刀治疗膝骨关节炎的近期总有效率和治愈率均优于关节腔注射玻璃酸钠,其合并的OR值及95%CI分别为:OR=2.18,95%CI[1.17,4.06];OR=1.86,95%CI[1.21,2.85]。结论:针刀治疗膝骨关节炎近期疗效优于关节腔注射玻璃酸钠。但纳入试验方法学质量不高,且均未报道不良事件,建议开展高质量的随机对照试验加以验证。

Objective： To assess the effectiveness and safety of acupotomy for knee osteoarthritis.Methods： Randomized controlled trials（RCTs） of acupotomy versus intra-articular sodium hyaluronate in the treatment of knee osteoarthritis were searched from CNKI,VIP,PubMed,and The Cochrane Central Register of Controlled Trials（Issue 3,2011）.The time limitation ran from the commencement of each database to September 15,2011.Data were extracted and evaluated by two reviewers independently.The Cochrane Collaboration＇s RevMan5.1 software was used for meta-analysis.Results： A total of 6 trials involving 429 patients were included.The meta-analyses showed that both curative rate and total effective rate of acupotomy are higher than intra-articular sodium hyaluronate in short term.It showed effects as follows respectively： OR=2.18,95%CI [1.17,4.06];OR=1.86,95%CI [1.21,2.85].Conclusion： Acupotomoy is more effective than intr-articular sodium hyaluronate in the treatment of knee osteoarthritis in short term.However,due to low quality of included studies and there are no studies reporting adverse events,further well-designed RCTs with high quality are still needed to evaluate the beneficial effects of acupotomoy.