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[1]徐斌,徐遠(yuǎn)坤,鄒海烽,等.口服補(bǔ)腎活血方藥聯(lián)合關(guān)節(jié)腔注射玻璃酸鈉治療膝骨關(guān)節(jié)炎的Meta分析[J].中醫(yī)正骨,2021,33(02):38-43.
　XU Bin,XU Yuankun,ZOU Haifeng,et al.Oral application of Bushen Huoxue(補(bǔ)腎活血)prescriptions combined with intra-articular injection of sodium hyaluronate for treatment of knee osteoarthritis:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(02):38-43.
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口服補(bǔ)腎活血方藥聯(lián)合關(guān)節(jié)腔注射玻璃酸鈉治療膝骨關(guān)節(jié)炎的Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年02期
頁(yè)碼:
38-43
欄目:
文獻(xiàn)研究
出版日期:
2021-02-20

文章信息/Info

Title:
Oral application of Bushen Huoxue(補(bǔ)腎活血)prescriptions combined with intra-articular injection of sodium hyaluronate for treatment of knee osteoarthritis:a meta analysis
作者:
徐斌; 徐遠(yuǎn)坤; 鄒海烽; 夏威夷; 楊進(jìn)鋒; 鄭為波
(貴州中醫(yī)藥大學(xué),貴州 貴陽(yáng) 550025)
Author(s):
XU Bin; XU Yuankun; ZOU Haifeng; XIA Weiyi; YANG Jinfeng; ZHENG Weibo
Guizhou University of Traditional Chinese Medicine,Guiyang 550025,Guizhou,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  補(bǔ)腎;  活血;  注射; 關(guān)節(jié)內(nèi);  透明質(zhì)酸;  Meta分析;  系統(tǒng)評(píng)價(jià)
Keywords:
osteoarthritis; knee;  reinforcing kidney;  activating blood;  injections; intra-articular;  hyaluronic acid;  meta-analysis;  systematic review
摘要:
目的:評(píng)價(jià)口服補(bǔ)腎活血方藥聯(lián)合關(guān)節(jié)腔注射玻璃酸鈉治療膝骨關(guān)節(jié)炎(knee osteoarthritis,KOA)的臨床療效。方法:應(yīng)用計(jì)算機(jī)檢索PubMed、Embase、The Cochrane Library、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)、中國(guó)知網(wǎng)、萬(wàn)方數(shù)據(jù)庫(kù)和維普網(wǎng)中關(guān)于口服補(bǔ)腎活血方藥聯(lián)合關(guān)節(jié)腔注射玻璃酸鈉治療KOA的隨機(jī)對(duì)照試驗(yàn)文獻(xiàn),檢索時(shí)限為建庫(kù)至2020年7月31日。對(duì)照組采用膝關(guān)節(jié)腔注射玻璃酸鈉注射液治療,治療組在對(duì)照組的基礎(chǔ)上口服補(bǔ)腎活血方藥,劑型不限。由2名研究人員獨(dú)立檢索、篩選文獻(xiàn),提取資料并評(píng)價(jià)納入研究的偏倚風(fēng)險(xiǎn)。采用Revman5.3軟件進(jìn)行Meta分析。結(jié)果:共檢索到1219篇文獻(xiàn),最終納入24篇。Meta分析結(jié)果顯示,治療組的治療有效率高于對(duì)照組[I2=0%,P=0.830; OR=5.29,95%CI(3.81,7.35),P=0.000]; 根據(jù)納入研究中的方劑藥物組成,將補(bǔ)腎活血方藥分為補(bǔ)腎輔以活血、活血輔以補(bǔ)腎及補(bǔ)腎活血兼祛風(fēng)濕3類,各亞組中治療組的治療有效率均高于對(duì)照組[補(bǔ)腎輔以活血:I2=0%,P=0.670; OR=5.98,95%CI(3.89,9.20),P=0.000。活血輔以補(bǔ)腎:I2=0%,P=0.770; OR=9.70,95%CI(3.24,29.04),P=0.000。補(bǔ)腎活血兼祛風(fēng)濕:I2=0%,P=0.950; OR=3.32,95%CI(1.84,5.99),P=0.000)]。治療組的膝關(guān)節(jié)疼痛視覺(jué)模擬量表評(píng)分低于對(duì)照組[I2=96%,P=0.000; MD=-1.30,95%CI(-1.81,-0.78),P=0.000]。治療組的西安大略和麥克馬斯特大學(xué)骨關(guān)節(jié)炎指數(shù)低于對(duì)照組[I2=97%,P=0.000; MD=-9.83,95%CI(-16.15,-3.51),P=0.002]。利用治療有效率作發(fā)表偏倚分析,漏斗圖顯示各研究點(diǎn)分布基本對(duì)稱,提示存在發(fā)表偏倚的可能性較小。結(jié)論:現(xiàn)有的證據(jù)表明,口服補(bǔ)腎活血方藥聯(lián)合關(guān)節(jié)腔注射玻璃酸鈉治療KOA的療效優(yōu)于單純關(guān)節(jié)腔注射玻璃酸鈉。
Abstract:
To evaluate the clinical curative effects of oral application of Bushen Huoxue(補(bǔ)腎活血,BSHX)prescriptions combined with intra-articular injection of sodium hyaluronate(SH)for treatment of knee osteoarthritis(KOA).Methods:All the randomized controlled trial(RCT)articles about oral application of BSHX prescriptions combined with intra-articular injection of SH for treatment of KOA included from database establishing to July 31,2020 were retrieved from PubMed,Embase,The Cochrane Library,Chinese biomedical literature database,China national knowledge internet,WanFang Database and VIP Database through computer.All patients in the 2 groups were treated with knee intra-articular injection of SH; moreover,the patients in treatment group were treated with oral application of BSHX prescriptions in any dosage forms.The articles were retrieved and screened and the information was extracted independently by two searchers.The risk of bias of included researches in the articles was assessed and a Meta-analysis was conducted by using Revman5.3 software.Results:One thousand two hundred and nineteen articles were searched out.After screening,24 articles were included in the final analysis.The results of Meta-analysis demonstrated that the clinical curative effective rates were higher in treatment group compared to control group(I2=0%,P=0.830; OR=5.29,95%CI(3.81,7.35),P=0.000).According to the drug combinations of prescriptions in included researches,the effects of BSHX prescriptions were divided into three categories including tonifying-kidney supplemented by activating-blood,activating-blood supplemented by tonifying-kidney and tonifying-kidney activating-blood combined with expelling wind-damp,and the clinical curative effective rates were higher in treatment subgroup compared to control subgroup(tonifying-kidney supplemented by activating-blood:I2=0%,P=0.670; OR=5.98,95%CI(3.89,9.20),P=0.000.activating-blood supplemented by tonifying-kidney:I2=0%,P=0.770; OR=9.70,95%CI(3.24,29.04),P=0.000.tonifying-kidney activating-blood combined with expelling wind-damp:I2=0%,P=0.950; OR=3.32,95%CI(1.84,5.99),P=0.000).The knee pain visual analogue scale(VAS)scores were lower in treatment group compared to control group(I2=96%,P=0.000; MD=-1.30,95%CI(-1.81,-0.78),P=0.000).The knee Western Ontario and McMaster Universities(WOMAC)osteoarthritis indexes were lower in treatment group compared to control group(I2=97%,P=0.000; MD=-9.83,95%CI(-16.15,-3.51),P=0.002).Publication bias was analyzed according to the clinical curative effective rates,and the basically symmetrical funnel plot demonstrated that publication bias was a remote possibility.Conclusion:Available evidences suggest that the combination therapy of oral application of BSHX prescriptions and knee intra-articular injection of SH surpasses the monotherapy of knee intra-articular injection of SH in clinical curative effects in treatment of KOA.

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備注/Memo

備注/Memo:
基金項(xiàng)目:國(guó)家自然科學(xué)基金項(xiàng)目(81860855); 貴州省中醫(yī)藥管理局中醫(yī)藥、民族醫(yī)藥科學(xué)技術(shù)研究課題(QZYY-2019-014)
通訊作者:徐遠(yuǎn)坤 E-mail:[email protected]
更新日期/Last Update: 2021-02-20