摘要
目的:利用Meta分析方法探讨高渗葡萄糖(高渗糖)膝关节局部注射(增生疗法)对膝骨关节炎(KOA)的治疗效果,为高渗糖注射治疗KOA提供理论依据。方法:利用PubMed、Scopus和the Cochrane Library等数据库检索关于高渗糖注射对KOA疗效的随机对照研究文献,按照循证医学系统的评价方法,逐一评价纳入研究的质量,提取有效的数据,采用RevMan 5.1软件对高渗糖注射组与对照组研究对象膝关节的疼痛、生理功能及僵硬等指标进行相关的Meta分析。结果:本研究共纳入5篇文献,共计355例患膝(234例患者)。Meta分析,高渗糖注射对KOA引发的疼痛有短期(SMD=-1.45,95%CI:-2.42~-0.48,P=0.003)及长期(SMD=-2.20,95%CI:-3.45~-0.94,P=0.000 6)缓解的效果。高渗糖局部注射可显著提高膝关节活动能力(SMD=-2.00,95%CI:-2.84~-1.55,P<0.000 01),但对对膝关节僵硬程度无明显改善(SMD=-0.05,95%CI:-1.02~0.03,P=0.07)。结论:高渗糖注射可有效改善KOA患者疼痛及关节活动能力,但对改善膝关节僵硬效果尚不确切。
Objective To investigate the curative effect of dextrose used in knee osteoarthritis(KOA)by applying a Meta-analysis,and to provide evidence for dextrose prolotherapy of KOA.Methods The literatures about the effect of dextrose prolotherapy in the treatment of KOA were retrieved from Pubmed/Medline,Scopus the and Cochrane Library.All the related literatures were checked and qualified in the method of evidence-based medicine.The improvement of pain,physical function,and stiffness relief were analyzed by RevMan 5.1between dextrose group and control group.Results Five case-control studies with a total of 355 knees from 234 patients were included.Meta-analysis showed that dextrose prolotherapy had both short-term and long-term effects on the pain relief(short term:SMD =-1.45,95% CI:-2.42--0.48,P=0.003;long-term:SMD =-2.20,95%CI:-3.45--0.94,P=0.000 6)in addition to physical function(SMD =-2.00,95% CI:-2.84--1.55,P<0.000 01).The stiffness improvement was not significant(SMD =-0.05,95% CI:-1.02-0.03,P=0.07).Conclusion For KOA,the dextrose prolotherapy could improve the symptoms of pain and physical function.But further studies are needed to exam its effects on stiffness.
引文
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