摘要
目的:系统评价中医推拿手法联合关节腔内注射玻璃酸钠治疗膝关节骨性关节炎(KOA)的有效性。方法:通过计算机检索2001年1月—2019年12月中国数字图书馆(CNKI)期刊全文数据库、重庆维普全文数据库(cqvip)、万方数据库、Cochrane Library数据库、美国医学文摘数据库相关文献,并查阅原文,检索公开发表的关于中医推拿手法联合关节腔内注射玻璃酸钠与单纯膝关节腔内注射玻璃酸钠治疗KOA的临床对照研究,应用统计软件RevMan5.3进行数据分析。结果:共检索出255篇文献,通过筛选最终纳入10篇文献,共有1016例患者满足纳入标准,全部为中文文献。对10篇文献进行Meta分析显示,中医推拿手法配合关节腔注射玻璃酸钠和单纯注射玻璃酸钠治疗KOA比较,分析使用固定效应模型,纳入文献的疗效评价及效应量OR=4.91,95%的CI为[3.05,7.91],效应合并值的假设检验Z=6.54,P<0.00001。漏斗图不呈倒漏斗型,基本呈下宽上窄左右对称的漏斗形,存在小部分倾斜,提示存在一定的发表性偏倚,估计与各临床研究质量不高有关。结论:中医推拿手法联合关节腔内注射玻璃酸钠治疗KOA安全有效,优于单一使用膝关节腔内注射玻璃酸钠的治疗方法。但是因纳入研究的文献质量不高和数量有限,亟待高质量的临床研究来进一步充实证据。
Objective: To evaluate the efficacy of Chinese massage combined with intra-articular injection of Sodium hyaluronate in the treatment of knee osteoarthritis (KOA). Methods: Computer searches the full-text database of Chinese Digital Library (CNKI) periodicals, Chongqing wipp full-text database (CQVIP) , Wanfang database, Cochrane Library database and American medical abstracts database, and consults the original text. To search the published clinical control study on the treatment of Koa by traditional Chinese massage combined with intra-articular injection of sodium hyaluronate and intra-articular injection of sodium hyaluronate alone, the data were analyzed by Rev Man 5.3. Results: A total of 255 articles were retrieved and 10 articles were selected. A total of 1016 patients met the inclusion criteria, all of them were in Chinese. A Meta-analysis of 10 articles showed that Chinese massage combined with intra-articular injection of sodium hyaluronate was used to treat Koa, and the fixed effect model was used, the 95 % CI was [3.05,7.91]. The hypothesis test of combined effect value z=6.54, p<0.000 01. The funnel diagram is not infundibulum-like, but is basically symmetrical in shape, with a small part of inclination, suggesting that there is some publication bias, which may be related to the poor quality of clinical research. Conclusion: TCM massage combined with sodium hyaluronate injection in the treatment of knee osteoarthritis has good clinical curative effects on KOA and has certain advantagescompared with the treatment of simple sodium hyaluronate injection. But restricted by the quality andquantity of the researches,these results need more evidence of clinical research with high quality to enrich.
作者
刘金浪
刘汝专
LIU Jin-lang;LIU Ru-zhuan(Yongxiu Hospital of Traditional Chinese Medicine,Yongxiu 330300,China;Ruikang Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530001,China.)
出处
《江西中医药大学学报》
2021年第4期27-31,共5页
Journal of Jiangxi University of Chinese Medicine
基金
广西壮族自治区中医药科技专项项目(GZKZ1140)。
