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[1]唐萌芽,翁祝承,邵利芳.中藥治療膝骨關(guān)節(jié)炎臨床療效和安全性的系統(tǒng)評價(jià)[J].中醫(yī)正骨,2014,26(01):43-48.
　Tang Mengya*,Weng Zhucheng,Shao Lifang..Systematic review on the clinical curative effects and safety of traditional chinese medicine in the treatment of knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(01):43-48.
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中藥治療膝骨關(guān)節(jié)炎臨床療效和安全性的系統(tǒng)評價(jià)()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期數(shù):
2014年01期
頁碼:
43-48
欄目:
骨關(guān)節(jié)炎
出版日期:
2014-01-28

文章信息/Info

Title:
Systematic review on the clinical curative effects and safety of traditional chinese medicine in the treatment of knee osteoarthritis
作者:
唐萌芽; 翁祝承; 邵利芳
浙江省富陽市中醫(yī)骨傷醫(yī)院,浙江 富陽 311400
Author(s):
Tang Mengya*; Weng Zhucheng; Shao Lifang.
*Fuyang TCM Orthopedic-Traumatological Hospital,Fuyang 311400,Zhejiang,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝 中草藥 消炎藥; 非甾類 Meta分析
Keywords:
Osteoarthritis; knee;  Drugs; Chinese herbal;  Anti-inflammatory agents; non-steroidal;  Meta-analysis
摘要:
目的:系統(tǒng)評價(jià)中藥治療膝骨關(guān)節(jié)炎的臨床療效和安全性。方法:運(yùn)用計(jì)算機(jī)檢索中國知網(wǎng)、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫2000年1月至2012年9月收錄的國內(nèi)公開發(fā)表的中藥治療膝骨關(guān)節(jié)炎的臨床研究文獻(xiàn),并進(jìn)行Meta分析。結(jié)果:共檢索出590篇相關(guān)文獻(xiàn),通過篩選最終有32篇文獻(xiàn)納入研究,涉及2 950例患者。納入文獻(xiàn)Jadad評分普遍不高,最高分為2分; 32篇文獻(xiàn)均說明了基線資料具有可比性; 3篇文獻(xiàn)采用隨機(jī)數(shù)字表進(jìn)行分組,3篇文獻(xiàn)按就診順序隨機(jī)分組,其余各篇隨機(jī)方法未說明; 各篇均未描述隨機(jī)分配方案的隱藏方法; 1篇文獻(xiàn)采用單盲,1篇文獻(xiàn)采用雙盲,其余各篇均未描述盲法; 各篇均未描述病例失訪或退出情況。對32篇文獻(xiàn)進(jìn)行合并分析顯示,治療組和對照組的有效率分別為64.01%和43.96%,治療組的臨床療效優(yōu)于對照組(Z=6.850,P=0.000),比數(shù)比=2.35,95%可信區(qū)間為1.84～3.01。20篇文獻(xiàn)提及對用藥安全性的觀察,其中15篇文獻(xiàn)記錄了患者用藥后不良反應(yīng)發(fā)生情況。治療組不良反應(yīng)發(fā)生率低于對照組(Z=8.870,P=0.000),比數(shù)比=0.14,95%可信區(qū)間為0.09～0.21。納入療效分析的32篇文獻(xiàn)及納入安全性評價(jià)的15篇文獻(xiàn)的漏斗圖均呈倒漏斗形,圖形兩側(cè)分布均勻,提示納入文獻(xiàn)發(fā)表性偏倚不明顯。結(jié)論:中藥治療膝骨關(guān)節(jié)炎療效優(yōu)于非甾類消炎藥,且不良反應(yīng)較少。但由于納入的文獻(xiàn)在方法學(xué)上存在問題,Meta分析得出的結(jié)論有一定的局限性,中藥治療膝骨關(guān)節(jié)炎的療效和安全性還需要大樣本、多中心、隨機(jī)雙盲的臨床對照試驗(yàn)來進(jìn)一步驗(yàn)證。
Abstract:
Objective:To review systematically the clinical curative effects and safety of traditional chinese medicine in the treatment of knee osteoarthritis(KOA).Methods:All the clinical research articles about traditional Chinese medicine for KOA included from January 2000 to September 2012 were retrieved from China national knowledge internet,Wanfang Database and Vip Database through computer,and then a meta-analysis was conducted.Results:Search terms yielded 590 articles and 32 articles(2 950 patients)were included in the final analysis.The Jadad scores of included articles were not high in general,and the highest score was two points.Comparable baseline data were demonstrated in all of the 32 articles.The random digits table was used for grouping in three articles,and randomization was performed according to the visit sequence in 3 articles,and the method of randomization was not mentioned in the other article.The hiding method for randomization was not described in all of the articles.Single blind was used in one article,double-blind was used in another article,and the blind method were not mentioned in other articles.The cases lost to follow-up and the cases dropped out of the study were not described in each article.Data from 32 articles were pooled and analyzed,and the results showed that the effective rate of treatment group and control group were 64.01% and 43.96% respectively,and the treatment group surpassed the control group in clinical curative effect(Z=6.850,P=0.000; odd ratio,2.35; 95% Confidence Interval 1.84 to 3.01).Observations on the safety of medication were mentioned in 20 articles,15 of which recorded the adverse drug reaction.The incidence rate of adverse reaction of treatment group was lower than that of control group(Z=8.870,P=0.000; odd ratio 0.14; 95% Confidence Interval 0.09 to 0.21).Funnel plots were inverted and symmetrical in 32 articles which involved the curative effect analysis and in 15 articles which involved the safety evaluation,and it indicated that the publication bias was not obvious.Conclusion:The traditional chinese medicine surpassed the non-steroidal anti-inflammatory agents in the clinical curative effects and in the incidence rate of adverse reactions.However,the included articles have problems in the method of research,so the conclusion based on meta analysis is limited.The clinical curative effects and safety of traditional chinese medicine in the treatment of KOA need to be further verified by large sample,multicenter,randomized,controlled,double-blind trails.

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更新日期/Last Update: 2014-01-20