推拿治疗膝关节骨性关节炎疗效Meta分析

Therapeutic effect of massage on knee osteoarthritis:a meta-analysis

目的运用循证医学系统评价方法评价单纯推拿治疗膝关节骨性关节炎(KOA)的疗效与安全性,为临床实践和研究提供参考。方法计算机检索考克兰图书馆(Cochrane Library)、PubMed医学文献检索服务系统、中国知网(CNKI)、维普资讯网(VIP)、万方数据知识服务平台)全面搜集推拿治疗KOA的随机对照试验(RCT),检索时限均从建库至2018年5月。3名研究者按照纳入与排除标准独立进行文献筛选、资料提取、质量评价和交叉审核后,采用Stata11.0软件进行Meta分析。结果最终纳入8篇随机对照试验,共涉及632例患者。对执行不同治疗干预措施的两组患者进行结果分析发现:与单纯药物组比较,单纯推拿组治愈率[OR=1.81,95%CI=1.14～2.88、愈显率[OR=2.03,95%CI=1.43～2.88]差异均有统计学意义(P<0.01);在不良反应方面,未见推拿治疗KOA的不良反应报告。结论现有临床证据表明,单纯推拿即可有效缓解KOA患者的临床症状,提高其生活质量,但因纳入文献普遍质量较低其疗效优势尚需进一步研究,特别需要高质量、多中心、大样本的RCT来验证。

Objective To use evidence-based medicine method to evaluate the efficacy and safety of massage alone in the treatment of for knee osteoarthritis(KOA), and to provide a reference for clinical practice and research.Methods Randomized controlled trials(RCT) of massage therapy for KOA were collected from Cochrane Library,PubMed, CNKI, VIP Information Network(VIP), Wanfang Data from inception to May 2018. Meta-analysis was performed using Stata11.0 software by three investigators after independent literature screening, data extraction, quality evaluation, and cross-examination according to inclusion and exclusion criteria. Results Eight RCTs were included, involving a total of 632 patients. Compared with the simple drug group, the simple massage group had significantly different cure rate(OR=1.81, 95% CI 1.14 to 2.88, P<0.01) and markedly effective rate(OR=2.03, 95% CI 1.43 to 2.88, P<0.01). No adverse reactions were reported for the treatment of KOA with massage. Conclusion The existing clinical evidence shows that massage alone can effectively alleviate the clinical symptoms of KOA patients and improve their quality of life. However, due to the low quality of the literature, its efficacy and advantages needs more high-quality,multi-center, large-sample RCTs to verify.