中西医结合治疗膝骨关节炎Meta分析

A Meta-analysis of treating knee osteoarthritis in the integrative medicine

目的:系统评价中西医结合治疗早、中期膝骨关节炎(Knee Osteoarthritis,KOA)的有效性及安全性。方法:计算机检索PubMed、Web of science、Cochrane、CBM、中国知网、维普、万方数据库中公开发表的中西医结合治疗KOA的随机对照试验。由2名研究人员独立检索、筛选文献,并对纳入的文献进行质量评价,使用WPS office进行数据提取及RevMan 5.3软件进行Meta分析。结果:共11篇文献符合纳入标准。Meta分析结果显示,临床有效率[RR=1.19,95%CI(1.13,1.27),P<0.00001]、西大略湖麦克马斯特大学骨关节指数评分(WOMAC)评分[MD=-8.89,95%CI(-9.50,-8.27),P<0.00001]、视觉模拟评分法(Visual Analogue Scale,VAS)评分[MD=-1.57,95%CI(-1.66,-1.48),P<0.00001],试验组三项指标的改善均优于对照组,其差异有统计学意义。不良反应率[OR=0.58,95%CI(0.13,2.52),Z=0.73,P=0.46],差异无明显统计学意义。结论:中西医结合治疗早、中期KOA较单纯西医治疗临床有效率更高、更能改善患者症状、减轻患者痛苦。但纳入Meta分析文献的质量不高,还需大量质量更高的文献提供充分的证据。

Objective:To systematically evaluate the effectiveness and safety of the integrative medicine in the treatment of early and middle stage KOA.Methods:Randomized controlled trials of treating the disease in the integrative medicine were searched by computer in PubMed,Web of Science,Cochrane,CBM,CNKI,VIP,and Wanfang database and so on.The literatures were independently searched and screened by two researchers,and the quality of the included literature was evaluated.The data was extracted by WPS office software.A Meta-analysis was executed by RevMan 5.3 software.Results:A total of 11 articles met the inclusion criteria.The Meta result showed that clinical efficacy[RR=1.19,95%CI(1.13,1.27),P<0.0001],WOMAC scores[MD=-8.89,95%CI(-9.50,-8.27),P<0.0001],and VAS scores[MD=-1.57,95%CI(-1.66,-1.48),P<0.00001]improvement in the test group were better than the control group,and the difference was statistically significant.The adverse reaction rate showed no statistically significant difference[OR=0.58,95%CI(0.13,2.25),Z=0.73,P=0.46].Conclusion:The integrative medicine on early and middle stage KOA is more effective than Western medicine,can improve the symptoms and alleviate the suffering of patients.However,the quality of the included literatures is not high,it need a large number of higher quality literature to provide sufficient evidences.