关节腔内注入玻璃酸钠与激素治疗膝关节骨性关节炎的Meta分析  

Intraarticular Sodium Hyaluronate Versus Corticosteroid in the Treatment of Knee Osteoarthritis:A Meta Analysis

作　　者：田昱平 彭飞[2] 姚亚洲[1] 

机构地区：[1]陕西省宝鸡市中心医院血液风湿科,721000 [2]陕西省宝鸡职业技术学院

出　　处：《中国全科医学》2011年第21期2420-2423,共4页Chinese General Practice

摘　　要：目的系统评价关节腔内注入玻璃酸钠与激素治疗膝关节骨性关节炎的有效性和安全性。方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP),手工检索相关领域的杂志全面查找符合标准的随机对照试验(RCT),用RevMan5.0软件进行统计分析。结果共纳入5篇RCT进行统计分析,Meta分析结果显示:关节腔内注入玻璃酸钠与激素治疗膝关节骨性关节炎的4周[MD=-4.12,95%CI(-7.83,-0.40)]、12周[MD=-4.49,95%CI(-7.75,-1.22)]时在疼痛缓解方面差异均有统计学意义,而在6个月时两组差异无统计学意义[MD=-2.82,95%CI(-5.00,-0.63)];在关节活动度方面两组差异有统计学意义[MD=4.25,95%CI(1.97,6.53)];纳入研究均提示两组在不良反应方面差异无统计学意义。结论当前研究证据可能表明在缓解关节疼痛方面激素短期效果优于玻璃酸钠,远期效果尚不确定;玻璃酸钠在改善关节活动度方面效果好,不良反应方面与激素无差异。上述结果尚需要高质量大样本的随机对照试验进一步证实。Objective To compare the efficacy and safety of intraarticular sodium hyaluronate and corticosteroid in the treatment of knee osteoarthritis through a meta analysis of randomized controlled trials（RCTs）.Methods RCTs met our criteria were enrolled from searching the Cochrane Library,PubMed,EMBASE,Chinese biomedical literature database,Chinese scientific journals full-text database,and Chinese journal full-text database and analyzed using Review Manager 5.0.Results Five randomized controlled trials were included.Meta analysis showed that significant differences exsisted between sodium hyaluronate and corticosteroid at the time point of 4 weeks[MD=-4.12,95%CI（-7.83,-0.40）] and 12 weeks[MD=-4.49,95%CI（-7.75,-1.22）] in terms of pain-releasing,while no difference was observed between the two groups at 6 months[MD=-2.82,95%CI（-5.00,-0.63）].Differences were observed between two groups in terms of knee flexion[MD=4.25,95%CI（1.97,6.53）].Conclusion Currently clinical studies might have confirmed that the short-term benefits of corticosteroid are superior to sodium hyaluronate in terms of pain-releasing in treatment of knee osteoarthritis.However it is difficult to determine the long-term benefits yet.Sodium hyaluronate appears to be more effective in terms of knee flexion than corticosteroid.And for incidence of adverse effects,no significant differences were noted.These results still need to be confirmed by RCTs of high quality and larger sample size.

关 键 词：玻璃酸钠 激素 骨关节炎 膝 META分析 

分 类 号：R684.3[医药卫生—骨科学]