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Low back pain-related meta-analysis:Caution is needed when interpreting published research results
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作者 Christophe Demoulin olivier bruyère +1 位作者 Pierre-René Somville Marc Vanderthommen 《World Journal of Meta-Analysis》 2015年第2期93-96,共4页
The systematic reviews(SRs) including a meta-analysis are considered as the top level of evidence.Although the existence of more than a hundred of low back pain(LBP)-related SRs seems very appealing and might therefor... The systematic reviews(SRs) including a meta-analysis are considered as the top level of evidence.Although the existence of more than a hundred of low back pain(LBP)-related SRs seems very appealing and might therefore suggest significant evidence on the topic,adeep analysis indicates that several of these SRs included only very few studies.Other SRs raise concerns because they included some randomized controlled trials which had a low methodological quality,or some studies which differed significantly regarding the studied populations and/or the experimental procedure.The sometimes controversial results of different SRs conducted on the same topic also highlight the significant influence of the inclusion/exclusion criteria used in the SRs to select the articles.To conclude,although meta-analysis is at the top of the evidence pyramid and have several strengths,the conclusions drawn from SRs should always be interpreted with caution because they can also have weaknesses.This is true,whether it be for LBP-related SRs including a meta-analysis,or any other.Therefore a critical analysis of any SR is always needed before integrating the results of the SR in its own clinical practice.Furthermore,clinical reasoning remains crucial,especially to consider the potential differences between one's patient and the patients included in the meta-analysis. 展开更多
关键词 META-ANALYSIS Systematic review SPINE Back pain LIMITATIONS RECOMMENDATIONS Evidencebased practice
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欧洲骨质疏松和骨关节炎临床及经济学协会(ESCEO)和中国骨关节炎领域专家联合发表声明:ESCEO膝骨关节炎治疗规则应同样适用于中国患者 被引量:20
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作者 张志毅 段新旺 +18 位作者 古洁若 黄慈波 姜林娣 林进 刘湘源 李泽光 马丽 齐文成 钱先 王吉波 王美美 武丽君 伍沪生 肖卫国 郑毅 张卓莉 olivier bruyère Jean-Yves Reginster Cyrus Cooper 《中国实用内科杂志》 CAS CSCD 北大核心 2016年第9期762-772,共11页
2014年12月,欧洲骨质疏松和骨关节炎临床及经济学协会(ESCEO)发布了膝骨关节炎(OA)治疗规则。此篇论文提供了中国OA专家将治疗规则应用于中国临床所做的评估和认可,目的是就如何为膝关节OA患者制定治疗流程提出切实可行的建议。在治疗的... 2014年12月,欧洲骨质疏松和骨关节炎临床及经济学协会(ESCEO)发布了膝骨关节炎(OA)治疗规则。此篇论文提供了中国OA专家将治疗规则应用于中国临床所做的评估和认可,目的是就如何为膝关节OA患者制定治疗流程提出切实可行的建议。在治疗的第1步,建议采用对症的缓慢起效骨关节炎治疗药物(SYSADOA)作为药物维持疗法,关于SYSADOA只有处方药结晶型硫酸氨基葡萄糖(p CGS)和处方药硫酸软骨素提供了高质量的证据。同时可合并扑热息痛等非甾体抗炎药物(NSAIDs),但只能作为紧急镇痛药物。外用非甾体抗炎药(NSAIDs)也可对症治疗。口服NSAIDs在第2步持续症状的高级治疗中维持核心作用。但是,口服NSAIDs在胃肠道和心血管安全性方面存在较大差异性。关节内注射透明质酸可产生持续临床益处,接受一个治疗疗程后,效应可持续长达6个月。作为手术之前的最后一步,缓释型曲马多(一种较弱的阿片类物质)可产生持续镇痛作用,且耐受性较好。 展开更多
关键词 非甾体抗炎药 处方药结晶型硫酸氨基葡萄糖 骨关节炎
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