藤黄健骨胶囊结合西医治疗膝关节骨性关节炎有效性和安全性的Meta分析

Efficacy and safety of Tenghuang Jiangu capsule combined with Western medicine in the treatment of knee osteoarthritis:a Meta-analysis

目的:系统评价藤黄健骨胶囊结合西医治疗膝关节骨性关节炎(KOA)的有效性和安全性。方法:应用Embase、PubMed、Cochrane Library、万方(WanFang)、中国知网(CNKI)、中国生物医学文献库(CBM)等数据库检索有关藤黄健骨胶囊结合西医治疗KOA的文献,严格按照纳排标准筛选出所需文献,使用Cochrane 5.1.0偏倚风险评估标准对文献进行评价,应用RevMan 5.4软件进行数据分析。结果:共纳入随机对照研究14项,涉及KOA患者1 531例。Meta分析结果显示藤黄健骨胶囊结合西医治疗KOA优于单纯西医治疗,其中有效率(OR=3.97,95%CI为2.50~6.30,P<0.05)、VAS评分(WMD=-1.06,95%CI为-1.37~-0.75,P<0.05)、Lysholm评分(WMD=11.35,95%CI为7.39~15.32,P<0.05)、白细胞介素-1β(IL-1β)水平(WMD=-13.32,95%CI为-21.70~-4.95,P<0.05)差异有统计学意义,而两组不良反应发生率差异无统计学意义(OR=0.81,95%CI为0.51~1.31),(P<0.40)。结论:藤黄健骨胶囊结合西医治疗KOA的疗效优于单纯西医治疗,但此结论尚待更多大样本、高质量的随机对照研究进行论证。

Objective:To evaluate the efficacy and safety of Tenghuang Jiangu capsule combined with Western medicine in the treatment of knee osteoarthritis(KOA).Methods:The Embase,PubMed,Cochrane Library,WanFang,CNKI,CBM were searched for the literatures on the treatment of osteoarthritis with Tenghuang Jiangu capsule combined with Western medicine,and the required literatures were screened out strictly according to the inclusion and exclusion criteria.Cochrane 5.1.0 bias risk assessment criteria was used to evaluate the literature,and RevMan 5.4 sofware was employed for data analysis.Results:A total of 14 literatures were included,involving 1531 patients with KOA.The results of Meta-analysis showed that the combination of Tenghuang Jiangu capsule and Western medicine in the treatment of osteoarthritis was better than that of western medicine alone,with an effective rate of(0R=3.97,95%CI2.50-6.30,P<0.05),VAS score of(WMD=-1.06,95%CI-1.37-0.75,P<0.05),Lysholm score of(WMD=11.35,95%CI 7.39-15.32,P<0.05)and IL-1βlevel of(WMD=-13.32,95%CI-21.70--4.95,P<0.05),the difference being statistically significant (P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(OR=0.81,95%CI 0.51-1.31,P<0.40).Conclusion:The efficacy of Tenghuang Jiangu capsule combined with Western medicine in the treatment of osteoarthritis is better than that of Western medicine alone.Large sample and high quality randomized controlled trials are needed to confirm the results.