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[1]葛海雅,鄢來軍,張燕,等.超聲引導下針刀松解術(shù)治療膝骨關(guān)節(jié)炎的有效性和安全性Meta分析…[J].中醫(yī)正骨,2020,32(10):42-46.
　GE Haiya,YAN Laijun,ZHANG Yan,et al.Clinical efficacy and safety of ultrasound-guided release with knife needle for treatment of knee osteoarthritis:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(10):42-46.
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超聲引導下針刀松解術(shù)治療膝骨關(guān)節(jié)炎的有效性和安全性Meta分析…()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年10期
頁碼:
42-46
欄目:
文獻研究
出版日期:
2020-10-20

文章信息/Info

Title:
Clinical efficacy and safety of ultrasound-guided release with knife needle for treatment of knee osteoarthritis:a meta analysis
作者:
葛海雅1; 鄢來軍1; 張燕1; 黃澤靈1; 耿秋東1; 李楠2
(1.福建中醫(yī)藥大學中醫(yī)學院,福建 福州 350122; 2.中醫(yī)骨傷及運動康復教育部重點實驗室,福建 福州 350122)
Author(s):
GE Haiya1; YAN Laijun1; ZHANG Yan1; HUANG Zeling1; GENG Qiudong1; LI Nan2
1.College of Traditional Chinese Medicine of Fujian University of Traditional Chinese Medicine,Fuzhou 350122,Fujian,China2.Key Laboratory of Orthopedics & Traumatology and Rehabilitation of Traditional Chinese Medicine of Ministry of Education,Fuzhou
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  超聲檢查;  小刀針;  Meta分析;  系統(tǒng)評價
Keywords:
osteoarthritis; knee;  ultrasonography;  small knife needle;  meta-analysis;  systematic review
摘要:
目的:系統(tǒng)評價超聲引導下針刀松解術(shù)治療膝骨關(guān)節(jié)炎(knee osteoarthritis,KOA)的有效性和安全性。方法:計算機檢索PubMed、Cochrane Library、中國知網(wǎng)、萬方數(shù)據(jù)庫、維普網(wǎng)建庫至2019年12月31日收錄的所有超聲引導下針刀松解術(shù)治療KOA的隨機對照研究或半隨機對照研究文獻。篩選文獻、提取數(shù)據(jù)并評價納入研究的偏倚風險后,采用Revman5.3軟件進行Meta分析。結(jié)果:最終納入8篇文獻,涉及446例KOA患者。治療組采用超聲引導下針刀松解治療,對照組采用普通針刀或針刺治療。Meta分析結(jié)果顯示,治療組的膝關(guān)節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評分低于對照組[I2=71%,P=0.001; MD=-1.05,95%CI(-1.50,-0.60),P=0.000]; 剔除2項研究后,重新進行Meta分析,固定效應(yīng)模型分析結(jié)果顯示,治療組的膝關(guān)節(jié)疼痛VAS評分低于對照組[I2=0%,P=0.580; MD=-0.78,95%CI(-1.00,-0.57),P=0.000]; 剔除的2項研究與其余6項研究相比,樣本量較少,考慮異質(zhì)性可能是樣本量不足造成的。治療組的膝關(guān)節(jié)屈伸活動度大于對照組[I2=0%,P=0.840; MD=4.44,95%CI(0.22,8.66),P=0.040],改良美國特種外科醫(yī)院膝關(guān)節(jié)評分高于對照組[I2=54%,P=0.140; MD=10.92,95%CI(5.53,16.31),P=0.000],總有效率高于對照組[I2=0%,P=0.530; OR=2.75,95%CI(1.42,5.31),P=0.003],不良反應(yīng)發(fā)生率低于對照組[I2=0%,P=0.650; OR=0.18,95%CI(0.05,0.66),P=0.009]。結(jié)論:現(xiàn)有的證據(jù)表明,超聲引導下針刀松解術(shù)是一種治療KOA的較為安全有效的方法,其療效和安全性優(yōu)于普通針刀或針刺治療。
Abstract:
To systematically review the clinical efficacy and safety of ultrasound-guided release with knife needle for treatment of knee osteoarthritis(KOA).Methods:All the randomized controlled trial(RCT)articles and controlled clinical trial(CCT)articles about ultrasound-guided release with knife needle for treatment of KOA included from database establishing to December 31,2019 were retrieved from PubMed,Cochrane Library,China national knowledge internet,WanFang Data and VIP Database through computer.The articles were screened and the information was extracted independently by two searchers.The risk of bias of included researches in the articles was assessed by using bias risk assessment tools recommended by Cochrane Handbook and a Meta-analysis was conducted by using Revman5.3 software.Results:Eight articles(446 patients)were included in the final analysis.The patients in treatment group were treated with ultrasound-guided release with knife needle,while the patients in control group were treated with conventional needle-knife therapy or acupuncture.The results of Meta-analysis demonstrated that the knee pain visual analogue scale(VAS)scores were lower in treatment group compared to control group(I2=71%,P=0.001; MD=-1.05,95%CI(-1.50,-0.60),P=0.000).The Meta-analysis was re-conducted after excluding 2 researches,and the results of analysis of fixed effect model demonstrated that the knee pain VAS scores were lower in treatment group compared to control group(I2=0%,P=0.580; MD=-0.78,95%CI(-1.00,-0.57),P=0.000).The samples were less in the 2 excluded researches compared to the other 6 researches.The heterogeneity might be caused by the insufficient samples.The knee flexion-extension range was greater(I2=0%,P=0.840; MD=4.44,95%CI(0.22,8.66),P=0.040),the improved Hospital for Special Surgery knee scores were higher(I2=54%,P=0.140; MD=10.92,95%CI(5.53,16.31),P=0.000),the total effective rate was higher(I2=0%,P=0.530; OR=2.75,95%CI(1.42,5.31),P=0.003)and the incidence rate of adverse reactions was lower(I2=0%,P=0.650; OR=0.18,95%CI(0.05,0.66),P=0.009)in treatment group compared to control group.Conclusion:Available evidences suggest that ultrasound-guided release with knife needle is a relatively safe and effective method for treatment of KOA,and it surpasses conventional needle-knife therapy or acupuncture in clinical curative effects and safety.

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備注/Memo

備注/Memo:
基金項目:福建省自然科學基金資助項目(2019J01349)
通訊作者:李楠 E-mail:[email protected]
更新日期/Last Update: 2020-10-20