针刀联合推拿治疗膝骨关节炎临床疗效的Meta分析

A Meta-analysis of Clinical Effect of Acupotomy Combined with Massage in the Treatment of Knee Osteoarthritis

目的系统评价针刀联合推拿治疗膝骨关节炎的临床疗效。方法计算机检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学信息网(CBM)、PubMed、Cochrane图书馆中关于针刀联合推拿治疗膝骨关节炎的临床随机对照试验(RCT)的文献,对符合纳入标准的文献采用Cochrane评价手册5.1推荐的RCT质量评价工具进行方法学质量评价,并提取患者一般资料及临床有效率,采用RevMan5.4软件进行Meta分析。结果共纳入16项RCTs,共1655例。Meta分析结果显示:针刀联合推拿治疗膝骨关节炎有效率明显优于对照组,差异有统计学意义[RR=1.18,95%CI(1.14,1.22),Z=9.04,P<0.0001];VAS疼痛评分的缓解上优于对照组,差异有统计学意义[MD=-1.16,95%CI(-2.48,0.17),Z=8.86,P<0.0001];有3项RCTs报告无明显不良反应。结论针刀联合推拿治疗膝骨关节炎临床疗效显著,在减少患者膝关节疼痛,改善患者生活质量方面优于其他疗法,是一种安全的治疗方法。

Objective:To systematically evaluate the clinical effect of acupotomy combined with massage in the treatment of knee osteoarthritis.Methods:CNKI,Wanfang,VIP,China Biomedical Information Network(CBM),PubMed,and Cochrane Library were searched by computer for clinical randomized controlled trials of acupotomy combined with massage in the treatment of knee osteoarthritis.For the literatures that met the inclusion criteria,the RCT quality evaluation tools recommended in Cochrane Evaluation Manual 5.1 were used to evaluate the methodological quality,and the general data and clinical effect of the patients were extracted.RevMan5.4 software was used for meta-analysis.Results:A total of 16 RCTs with 1655 cases were included.The meta-analysis results showed that the effective rate of acupuncture combined with massage in the treatment of knee osteoarthritis was significantly better than that of the control group[RR=1.18,95%CI(1.14,1.22),Z=9.04,P<0.0001].The relief of VAS pain score was better than that of the control group,and the difference was statistically significant[MD=-1.16,95%CI(-2.48,0.17),Z=8.86,P<0.0001].3 RCTs reported no significant adverse reactions.Conclusion:Acupotomy combined with massage has a significant clinical effect in the treatment of knee osteoarthritis.This treatment is better than other therapies in reducing knee pain and improving the quality of life of patients and is a safe treatment method.