高渗葡萄糖局部注射治疗膝骨关节炎疗效的Meta分析  

Meta-analysis on curative effect of dextrose prolotherapy for knee oteoarthritis

作　　者：叶冬梅[1] 陈琛[2] 林紫薇[3] 徐义明[1] 白跃宏[1] 

机构地区：[1]上海交通大学附属第六人民医院康复医学科,上海200233 [2]大连大学医学院解剖学教研室,辽宁大连116021 [3]上海市第十人民医院内分泌与代谢科,上海200072

出　　处：《吉林大学学报（医学版）》2015年第3期612-618,共7页Journal of Jilin University：Medicine Edition

基　　金：上海市科委科技惠民项目资助课题(13231202600)

摘　　要：目的:利用Meta分析方法探讨高渗葡萄糖(高渗糖)膝关节局部注射(增生疗法)对膝骨关节炎(KOA)的治疗效果,为高渗糖注射治疗KOA提供理论依据。方法:利用PubMed、Scopus和the Cochrane Library等数据库检索关于高渗糖注射对KOA疗效的随机对照研究文献,按照循证医学系统的评价方法,逐一评价纳入研究的质量,提取有效的数据,采用RevMan 5.1软件对高渗糖注射组与对照组研究对象膝关节的疼痛、生理功能及僵硬等指标进行相关的Meta分析。结果:本研究共纳入5篇文献,共计355例患膝(234例患者)。Meta分析,高渗糖注射对KOA引发的疼痛有短期(SMD=-1.45,95%CI:-2.42^-0.48,P=0.003)及长期(SMD=-2.20,95%CI:-3.45^-0.94,P=0.000 6)缓解的效果。高渗糖局部注射可显著提高膝关节活动能力(SMD=-2.00,95%CI:-2.84^-1.55,P<0.000 01),但对对膝关节僵硬程度无明显改善(SMD=-0.05,95%CI:-1.02~0.03,P=0.07)。结论:高渗糖注射可有效改善KOA患者疼痛及关节活动能力,但对改善膝关节僵硬效果尚不确切。Objective To investigate the curative effect of dextrose used in knee osteoarthritis（KOA）by applying a Meta-analysis,and to provide evidence for dextrose prolotherapy of KOA.Methods The literatures about the effect of dextrose prolotherapy in the treatment of KOA were retrieved from Pubmed/Medline,Scopus the and Cochrane Library.All the related literatures were checked and qualified in the method of evidence-based medicine.The improvement of pain,physical function,and stiffness relief were analyzed by RevMan 5.1between dextrose group and control group.Results Five case-control studies with a total of 355 knees from 234 patients were included.Meta-analysis showed that dextrose prolotherapy had both short-term and long-term effects on the pain relief（short term：SMD =-1.45,95% CI：-2.42--0.48,P=0.003;long-term：SMD =-2.20,95%CI：-3.45--0.94,P=0.000 6）in addition to physical function（SMD =-2.00,95% CI：-2.84--1.55,P〈0.000 01）.The stiffness improvement was not significant（SMD =-0.05,95% CI：-1.02-0.03,P=0.07）.Conclusion For KOA,the dextrose prolotherapy could improve the symptoms of pain and physical function.But further studies are needed to exam its effects on stiffness.

关 键 词：高渗右旋葡萄糖 增生疗法 膝关节 骨性关节炎 META分析 

分 类 号：R684[医药卫生—骨科学]