[1]徐斌,徐远坤,邹海烽,等.口服补肾活血方药联合关节腔注射玻璃酸钠治疗膝骨关节炎的Meta分析[J].中医正骨,2021,33(02):38-43.
　XU Bin,XU Yuankun,ZOU Haifeng,et al.Oral application of Bushen Huoxue(补肾活血)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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口服补肾活血方药联合关节腔注射玻璃酸钠治疗膝骨关节炎的Meta分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年02期
页码:
38-43
栏目:
文献研究
出版日期:
2021-02-20

文章信息/Info

Title:
Oral application of Bushen Huoxue(补肾活血)prescriptions combined with intra-articular injection of sodium hyaluronate for treatment of knee osteoarthritis:a meta analysis
作者:
徐斌; 徐远坤; 邹海烽; 夏威夷; 杨进锋; 郑为波
(贵州中医药大学,贵州 贵阳 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
关键词:
骨关节炎; 膝;  补肾;  活血;  注射; 关节内;  透明质酸;  Meta分析;  系统评价
Keywords:
osteoarthritis; knee;  reinforcing kidney;  activating blood;  injections; intra-articular;  hyaluronic acid;  meta-analysis;  systematic review
摘要:
目的:评价口服补肾活血方药联合关节腔注射玻璃酸钠治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法:应用计算机检索PubMed、Embase、The Cochrane Library、中国生物医学文献数据库、中国知网、万方数据库和维普网中关于口服补肾活血方药联合关节腔注射玻璃酸钠治疗KOA的随机对照试验文献,检索时限为建库至2020年7月31日。对照组采用膝关节腔注射玻璃酸钠注射液治疗,治疗组在对照组的基础上口服补肾活血方药,剂型不限。由2名研究人员独立检索、筛选文献,提取资料并评价纳入研究的偏倚风险。采用Revman5.3软件进行Meta分析。结果:共检索到1219篇文献,最终纳入24篇。Meta分析结果显示,治疗组的治疗有效率高于对照组[I2=0%,P=0.830; OR=5.29,95%CI(3.81,7.35),P=0.000]; 根据纳入研究中的方剂药物组成,将补肾活血方药分为补肾辅以活血、活血辅以补肾及补肾活血兼祛风湿3类,各亚组中治疗组的治疗有效率均高于对照组[补肾辅以活血:I2=0%,P=0.670; OR=5.98,95%CI(3.89,9.20),P=0.000。活血辅以补肾:I2=0%,P=0.770; OR=9.70,95%CI(3.24,29.04),P=0.000。补肾活血兼祛风湿:I2=0%,P=0.950; OR=3.32,95%CI(1.84,5.99),P=0.000)]。治疗组的膝关节疼痛视觉模拟量表评分低于对照组[I2=96%,P=0.000; MD=-1.30,95%CI(-1.81,-0.78),P=0.000]。治疗组的西安大略和麦克马斯特大学骨关节炎指数低于对照组[I2=97%,P=0.000; MD=-9.83,95%CI(-16.15,-3.51),P=0.002]。利用治疗有效率作发表偏倚分析,漏斗图显示各研究点分布基本对称,提示存在发表偏倚的可能性较小。结论:现有的证据表明,口服补肾活血方药联合关节腔注射玻璃酸钠治疗KOA的疗效优于单纯关节腔注射玻璃酸钠。
Abstract:
To evaluate the clinical curative effects of oral application of Bushen Huoxue(补肾活血,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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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81860855); 贵州省中医药管理局中医药、民族医药科学技术研究课题(QZYY-2019-014)
通讯作者:徐远坤 E-mail:xyk_2005@163.com
更新日期/Last Update: 2021-02-20