毫针针刺治疗骨关节炎疗效的Meta分析

Meta-Analysis of the Therapeutic Effect of Treating Osteoarthritis with Filiform Needle

目的:系统评价毫针针刺治疗骨关节炎的临床疗效。方法:计算机检索Cochrane Library、Pub Med、中国知网、维普、万方数据库,符合纳入标准的随机对照试验文献按照Cochrane系统评价员手册5.1.0版进行偏倚风险及质量评估,使用Rev Man 5.3软件进行Meta分析。结果:本研究共纳入16篇文献,累计观察骨关节炎患者3317例。研究结果显示,在安全性方面,所纳入的试验均无严重不良事件;治疗总有效率OR=1.58,95%CI=[1.28,1.96],P<0.000 1,治疗后关节疼痛症状SMD=-0.50,95%CI=[-0.79,-0.21],P=0.000 8,关节功能SMD=-0.53,95%CI=[-0.82,-0.25],P=0.000 3,患者生活质量SMD=0.39,95%CI=[0.18,0.59],P=0.000 3,疗效持久性SMD=-0.22,95%CI=[-0.39,-0.04],P=0.01,针刺组均优于对照组。结论:毫针针刺治疗骨关节炎有效,且在改善关节疼痛症状、功能及患者身心健康等方面有优势,疗效持久,安全性较高。但因纳入文献数量与质量的局限,疗效评定可能存在部分偏倚,尚需更多高质量的随机对照试验继续验证。

Objective：To systematically evaluate the clinical efficacy of treating osteoarthritis with filiform needle.Methods：RCT （ randomized controlled trials ） literatures were retrieved from Cochrane Library, CNKI,PubMed,VIP, and Wanfang database,and their bias risk and quality were evaluated with the Cochrane Handbook of the 5.1.0 version.The Meta-analysis was made with RevMan 5.3 software.Results：A total of 16 articles were included in this study and there were 3317 patients with osteoarthritis observed.The research results showed that in terms of security, the trials were of no serious adverse events.The total efficiency of treatment was OR = 1.58,95%CI = [ 1.28,1.96 ] ,P 〈 0.000 1.After treatment,the joint pain symptom was SMD = -0.50,95%CI ： [ -0.79,-0.21 ] ,P = 0.000 8.The joint function was SMD = -0.53,95%CI = [ -0.82,-0.25 ] , P = 0.000 3.The quality of life of patients was SMD = 0.39,95%CI = [ 0.18,0.59 ] ,P = 0.000 3.The persistent effect was SMD = -0.22,95%CI = [ -0.39,-0.04 ] ,P = 0.01.As for above indexes,the acupuncture group was better than the control group.Conclusion：Acupuncture therapy with filiform needle is effective for osteoarthritis,which can improve the joint pain symptom,joint function and physical and mental condition,with lasting effect and high security.However,due to the limitations of the quantity and quality of the included literature,there may be some biases in the evaluation of the therapeutic effect,so further validation is still needed.