温针灸治疗膝骨关节炎的系统评价  

Efficacy of needle warming therapy for treatment of knee osteoarthritis: a systematic review

作　　者：郭凯云 陈东林[1] GUO Kaiyun;CHEN Donglin(Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China)

机构地区：[1]浙江中医药大学,浙江杭州310053

出　　处：《中医正骨》2018年第7期17-20,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:评价温针灸治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法:应用计算机检索Pub Med、The Cochrane Library、CBM、CNKI、Wan Fang Data、VIP数据库建库至2017年10月收录的所有温针灸(温针灸组)和口服西药(西药组)治疗KOA的随机对照研究文献。由2位研究者独立筛选文献、提取资料,依据Cochrane Handbook5.1.0进行文献方法学质量评价后,采用RevMan5.3软件进行Meta分析。结果:初检共检索出266篇文献,经筛选后最终纳入11篇文献,均为中文文献。Meta分析结果显示,温针灸组的总有效率高于西药组[OR=4.54,95%CI(3.02,6.82)];温针灸组治疗后的西安大略和麦克马斯特大学骨关节炎指数总分小于西药组[MD=-0.68,95%CI(-1.02,-0.35)]。利用总有效率进行发表偏倚分析,漏斗图显示分布不对称,存在一定的发表偏倚。结论:温针灸是治疗KOA的有效方法,其疗效优于单纯口服西药。但仍需开展多中心、大样本、高质量的随机对照试验加以证实。Objective：To evaluate the clinical curative effect of needle warming therapy in the treatment of knee osteoarthritis（KOA）. Methods：All the randomized controlled trial（RCT） articles about needle warming therapy（ needle warming therapy group）versus oral application of western medicine therapy（western medicine therapy group）for treatment of KOA included from database establishing to October 2017 were retrieved from PubMed, The Coehrane Library, CBM, China national knowledge intemet, WanFang Data and VIP Database through computer. The articles were screened and the information was extracted independently by two searchers. The methodological quality of research in the articles was evaluated according to Cochrane Handbook 5.1.0 and a Meta - analysis was conducted by using RevMan 5.3 software. Results：Two hundred and sixty- -six articles were searched out. After screening, 11 Chinese articles were included in the final analysis. The results of Meta - analysis demonstrated that the total effective rate was higher and the posttreatment Western Ontario and Me - Master Universities （WOMAC）osteoarthritis index scores were lower in needle warming therapy group compared to western medicine therapy group（ OR = 4.54,95 % CI（3.02,6.82） ;MD = - 0.68,95 % CI（ - 1.02, - 0.35） ）. According to the total effective rate, the asymmetrical funnel plot demonstrated that there was publication bias. Conclusion：Needle warming therapy is an effective method for treatment of KOA, and it surpasses the monotherapy of oral application of western medicines in the clinical curative effect. However, its clinical curative effect need to be further verified by multi -center, large sample, high -quality- RCTs.

关 键 词：骨关节炎 膝 温针疗法 META分析 系统评价 

分 类 号：R246.9[医药卫生—针灸推拿学]