摘要
目的系统评价温针灸联用玻璃酸钠治疗膝骨性关节炎的效果和安全性。方法检索PubMed、EMbase、Cochrane Library、CBM、WF、CNKI和VIP数据库建库至2018年7月21日关于温针灸联用玻璃酸钠治疗膝骨性关节炎的随机对照试验(RCT)和临床对照试验(CCT),并对全部纳入研究的参考文献进行追溯,由2个评价员根据纳入排除标准独立对纳入研究进行筛选和评价,然后进行数据提取。运用RevMan 5.3软件进行统计分析。结果共纳入20篇文献,共1719例患者,联合治疗组859例,玻璃酸钠组860例,经Meta分析表明:联合组对膝骨性关节炎疗效优于玻璃酸钠组(OR=4.45,95%CI:3.12～6.35,P <0.05)。各组均未发生不良反应。结论温针灸联用玻璃酸钠治疗膝骨性关节炎疗效显著,安全性较好。
Objective To systematically evaluate the curative effect and safety of warm acupuncture combined with Sodium Hyaluronate therapy in treatment of knee osteoarthritis. Methods The databases of PubMed, EMbase, Cochrane Library, CBM, WanFang, CNKI and VIP were retrieved for collecting randomized controlled trials(RCT) and clinic controlled trials(CCT) about warm acupuncture combined with Sodium Hyaluronate therapy in treatment of knee osteoarthritis from database building to July 21 th, 2018, and reference lists enrolled were also searched. According to the inclusion and exclusion criteria, two reviewers screened and assessed the enrolled studies independently, and then the data was extracted. The data was given a Meta-analysis by using RevMan 5.3 software. Results A total of 20 studies were included, involving 1719 patients, with 859 cases in combination group and 860 cases in Sodium Hyaluronate group. The Meta-analysis showed: the clinical curative effect of the combination group in treating knee osteoarthritis was better than the Sodium Hyaluronate group(OR = 4.45, 95%CI: 3.12-6.35, P < 0.05). There were no adverse reactions in each group. Conclusion The combination treatment of warm acupuncture and Sodium Hyaluronate has significant curative effect, and the safety is good.
引文
[1]Gardiner BS,Woodhouse FG,Besier TF,et al.Predicting Knee Osteoarthritis[J].Ann Biomed Eng,2016,44(1):222-233.
[2]中国中西医结合学会骨伤科专业委员会关节工作委员会中国中医药研究促进会骨科专业委员会.膝骨关节炎中医诊疗专家共识(2015年版)[J].中医正骨,2015,27(7):4-5.
[3]张慧铭,陈燕超,何剑全.温针灸联合关节腔注射玻璃酸钠治疗轻、中度膝骨关节炎临床观察[J].风湿病与关节炎,2018,7(5):22-24,47.
[4]李洪涛,赵超越,宋茂林.温针灸联合玻璃酸钠关节腔内注射治疗膝骨性关节炎临床观察[J].亚太传统医药,2018,14(1):166-168.
[5]梁廷营.针灸联合玻璃酸钠治疗膝关节骨性关节炎50例[J].中医研究,2018,31(5):55-57.
[6]欧梁,张林,王琼,等.温针灸联合关节腔注射对膝骨关节炎临床疗效的随机对照研究[J].针灸临床杂志,2018,34(1):8-11.
[7]戴丽莉,候转转.温针灸联合玻璃酸钠治疗膝关节骨性关节炎30例疗效观察[J].浙江中医杂志,2018,53(3):209.
[8]陈娟,沈娟,陈政,等.温针灸联合玻璃酸钠关节腔注射治疗膝骨关节炎疗效及对MMPs的影响[J].世界中医药,2017,12(12):3102-3105.
[9]吴志咏.温针灸配合玻璃酸钠治疗膝骨关节炎的疗效观察[J].临床医药文献电子杂志,2017,4(33):6467-6468.
[10]高焱.关节腔注射玻璃酸钠结合针灸治疗膝关节骨性关节炎效果观察[J].中国疗养医学,2017,26(12):1258-1260.
[11]郑志伟.玻璃酸钠联合针灸治疗膝关节骨性关节炎临床疗效观察[J].现代诊断与治疗,2017,28(9):1599-1600.
[12]喻学春,蔺盛世.玻璃酸钠结合温针灸治疗膝骨关节炎疗效观察[J].山西中医,2016,32(4):30-32.
[13]汉东明,张红丽.温针灸联合玻璃酸钠关节内注射治疗膝关节骨性关节炎64例[J].中国中医药现代远程教育,2016,14(8):112-113.
[14]梁晶亮,李亮.玻璃酸钠配合温针灸治疗寒湿痹阻型二期KOA临床研究[J].现代中医药,2016,36(2):33-35.
[15]左朝.温针灸对膝骨性关节炎患者自由基代谢的影响[J].针灸临床杂志,2015,31(10):49-51.
[16]陈涧淡.玻璃酸钠结合针灸治疗膝骨关节炎100例临床观察[J].中外女性健康研究,2015(7):197,210.
[17]刘鹏,王强,陈志,等.滞针温针灸配合玻璃酸钠治疗膝骨关节炎疗效观察[J].上海针灸杂志,2014,33(12):1152-1155.
[18]蒋宁茂.针灸联合玻璃酸钠治疗膝关节骨性关节炎疗效观察[J].广西中医药,2014,37(5):46-48.
[19]任景,李涛.温针灸联合玻璃酸钠关节腔注射治疗膝关节骨性关节炎疗效观察[J].新疆医科大学学报,2012,35(9):1212-1215.
[20]梁玉萍,梁玉凤.温针灸配合关节腔注射玻璃酸钠注射液治疗膝关节骨性关节炎30例疗效观察[J].新中医,2012,44(7):128-129.
[21]王慧芳,程少丹,李伟,等.银针联合玻璃酸钠治疗膝骨关节炎的随机对照研究[J].上海针灸杂志,2011,30(4):250-251.
[22]王琼芬,李曦.温针灸配合玻璃酸钠膝关节腔内注射治疗虚寒型膝骨性关节炎疗效观察[J].中国康复医学杂志,2010,25(11):1094-1097.
[23]石海卫,李丽.温针结合玻璃酸钠治疗早中期膝骨性关节炎临床观察[J].山西中医,2016,32(2):41-42.
[24]Cross M,Smith E,Hoy D,et al.The global burden of hip and knee osteoarthritis:estimates from the global burden of disease 2010 study[J].Ann Rheum Dis,2014,73(7):1323-1330.
[25]Lee S,Kim SJ.Prevalence of knee osteoarthritis,risk factors,and quality of life:The Fifth Korean National Health And Nutrition Examination Survey[J].Int J Rheum Dis,2017,20(7):809-817.
