中药熏洗联合西药治疗膝骨关节炎疗效与安全性的系统评价  

Systematic Evaluation of Effectiveness and Safety of Chinese Medicine Fumigation and Washing Combined with Western Medicine in the Treatment of Knee Oosteoarthritis

作　　者：董邱 查振刚[1,2] 张荣华[3,4] 陈均源[1,2] 刘日许 张还添 DONG Qiu;ZHA Zhen-Gang;ZHANG Rong-Hua;CHEN Jun-Yuan;LIU Ri-Xu;ZHANG Huan-Tian(The First Clinical Medical School,Jinan University,Guangzhou 510630 Guangdong,China;Centre of Bone,Joint and Sports Medicine,the First Affiliated Hospital of Jinan University,Guangzhou 510630 Guangdong,China;Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informationalization,Jinan University,Guangzhou 510630 Guangdong,China;Institute of Oncology,Jinan University,Guangzhou 510630 Guangdong,China)

机构地区：[1]暨南大学第一临床医学院,广东广州510630 [2]暨南大学附属第一医院骨关节与运动医学中心,广东广州510630 [3]暨南大学广东省中医药信息化重点实验室,广东广州510630 [4]暨南大学肿瘤研究所,广东广州510630

出　　处：《广州中医药大学学报》2022年第5期1208-1214,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:82072470);国家自然科学基金面上项目(编号:81871809);国家重点研发计划项目(编号:2018YF C2002500);广东省自然科学基金项目(编号:2020A1515010645);广东省科技计划项目-广东省中医药信息化重点实验室(编号:2021B1212040007)

摘　　要：【目的】系统评价中药熏洗联合西药治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效与安全性。【方法】检索万方数据库(Wanfang Data)、中国知网数据库(CNKI)、中国生物医学文献数据库(CBM)、维普中文期刊数据库(VIP)、Cochrane Library、Embase、Web of Science、PubMed以及临床实验注册中心关于中药熏洗联合西药治疗KOA的随机对照试验(RCTs),依据Cochrane指南对纳入文献进行质量评估,采用RevMan 5.3软件进行Meta分析。【结果】共纳入12篇文献,总计997例患者。Meta分析结果显示,中药熏洗联合西药治疗KOA的总有效率高于单纯西药治疗[RR=1.13,95%CI(1.08,1.19),P<0.00001],且在缓解KOA患者疼痛视觉模拟量表(VAS)评分[WMD=-0.91,95%CI(-1.54,-0.29),P<0.05]方面具有一定优势,同时两组的不良反应发生率[RR=0.34,95%CI(0.02,4.71),P=0.42]无明显差异。【结论】中药熏洗联合西药治疗KOA可以提升单纯西药治疗的疗效,且不会增加不良反应。因受纳入研究数量及质量的限制,结论有待大样本、多中心、高质量的临床试验进一步证实。Objective To systematically evaluate the clinical efficacy and safety of Chinese medicine fumigation and washing combined with western medicine in the treatment of knee osteoarthritis(KOA).Methods Randomized controlled trials(RCTs)of KOA treated by Chinese medicine fumigation and washing combined with western medicine were retrieved from the databases of Wanfang Data,CNKI,CBM,VIP,Cochrane Library,Embase,Web of Science,and PubMed as well as the clinical trial registry.The quality of the included literature was assessed according to the Cochrane guidelines,and the meta-analysis was conducted with RevMan5.3 software.Results A total of 12 RCTs were included with a total of 997 patients.Meta-analysis results showed that the total effective rate of Chinese medicine fumigation and washing combined with western medicine was higher than that of western medicine alone[RR=1.13,95%CI(1.08,1.19),P<0.00001].In addition,the combined therapy had certain advantages in decreasing visual analogue scale(VAS)scores of pain in KOA patients[WMD=-0.91,95%CI(-1.54,-0.29),P<0.05],but there was no significant difference in the incidence of adverse reactions between the two groups[RR=0.34,95%CI(0.02,4.71),P=0.42].Conclusion Chinese medicine fumigation and washing combined with western medicine is more effective than western medicine alone,without increasing adverse reactions.For the disadvantages of the quantity and quality of the included studies,the conclusion still needs to be further verified by large sample-size,multi-center and high-quality clinical trials.

关 键 词：中药熏洗 膝骨关节炎 随机对照试验 系统评价 META分析 

分 类 号：R684.3[医药卫生—骨科学]