单用氨基葡萄糖治疗骨关节炎有效性和安全性的Meta分析

Meta-analysis of the Efficacy and Safety of Glucosamine Alone in the Treatment of Osteoarthritis

目的系统评价单独使用氨基葡萄糖治疗骨关节炎的有效性和安全性,为临床上使用氨基葡萄糖治疗骨关节炎提供循证参考。方法检索CNKI、VIP、CBM、WanFang Data、PubMed、EMbase和The Cochrane Library等中外文数据库,收集建库以来至2021年6月30日公开发表的单独使用氨基葡萄糖治疗骨关节炎的随机对照试验(RCTs)文献。采用VAS疼痛评分、WOMAC评分以及药物不良反应发生率等指标系统评价单独使用氨基葡萄糖治疗骨关节炎的有效性及安全性。采用RevMan5.4软件进行Meta分析。结果共有11篇RCTs文献纳入Meta分析,包括1962例患者,其中试验组985例,对照组977例。Meta分析结果显示,以VAS评分改变量进行Meta分析时,试验组与对照组比较差异无统计学意义[MD=-0.13,95%CI(-0.49,0.23)],P=0.47];以WOMAC疼痛评分改变量进行Meta分析,试验组与对照组比较差异无统计学意义[MD=-1.13,95%CI(-3.18,0.92),P=0.28];以WOMAC身体功能评分改变量进行Meta分析,试验组与对照组比较差异无统计学意义[MD=-1.18,95%CI(-3.05,0.69),P=0.21];以WOMAC总评分改变量进行Meta分析,试验组与对照组比较差异无统计学意义[MD=-1.39,95%CI(-5.84,3.06),P=0.54];以不良事件发生情况进行Meta分析,试验组与对照组比较差异无统计学意义[OR=1.10,95%CI(0.56,2.15),P=0.78]。结论单用氨基葡萄糖(≤1500 mg/d)未减轻骨关节炎疼痛和改善骨关节功能,但其安全性较好。提示需要更多高质量的研究明确其疗效。

Objective To systematically evaluate the efficacy and safety of glucosamine alone in the treatment of osteoarthritis,and to provide evidence-based reference for the clinical use of glucosamine in the treatment of osteoarthritis.Methods CNKI,VIP,CBM,WanFang Data,PubMed,EMbase and The Cochrane Library were searched to collect the randomized controlled trials(RCTs)of glucosamine alone in the treatment of osteoarthritis published from the establishment of the database to June 30,2021.The efficacy and safety of glucosamine alone in the treatment of osteoarthritis were systematically evaluated by VAS pain score,WOMAC score and incidence of adverse drug reactions.Meta-analysis was performed using RevMan 5.4 software.Results A total of 11 RCTs studies involving 1962 patients were included(985 patients in the experimental group and997 patients in the control group).The meta-analyses were performed by VAS score changes,there was no statistically significant difference between the experimental group and the control group[MD=-0.13,95%CI(-0.49,0.23)],P=0.47];the meta-analysis was performed by the amount of WOMAC pain score change,and there was no statistically significant difference between the experimental group and the control group[MD=-1.13,95%CI(-3.18,0.92),P=0.28];the meta-analysis was performed by the amount of change in WOMAC body function score,and the difference between the experimental group and the control group was not statistically significant[MD=-1.18,95%CI(-3.05,0.69),P=0.21];The meta-analysis was performed by the WOMAC total score change,and the difference between the experimental group and the control group was not statistically significant[MD=-1.39,95%CI(-5.84,3.06),P=0.54];the meta-analysis was performed by the adverse events,there was no statistically significant difference between the experimental group and the control group[OR=1.10,95%CI(0.56,2.15),P=0.78].Conclusion Glucosamine alone(≤1500 mg/d)does not reduce osteoarthritis pain and improve bone and joint function,but it is safe.It is suggested that more high-quality studies are needed to clarify its efficacy.