浮针治疗膝关节骨性关节炎安全性与有效性的Meta分析  

Meta-analysis of Safety and Effectiveness of Floating Needle Therapy in Treating Knee Osteoarthritis

作　　者：刘婉君 危志华 韩慧 魏宁 邓宝贵 吴小婉[1] 张泱悦[3] LIU Wan-Jun;WEI Zhi-Hua;HAN Hui;WEI Ning;DENG Bao-Gui;WU Xiao-Wan;ZHANG Yang-Yue(School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006 Guangdong, China;Xinhua Collegeof Sun Yat-Sen University, Guangzhou 523000 Guangdong, China;The First Affiliated Hospital of GuangzhouUniversity of Chinese Medicine, Guangzhou 510405 Guangdong, China)

机构地区：[1]广州中医药大学护理学院,广东广州510006 [2]中山大学新华学院,广东广州523000 [3]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2019年第10期1554-1562,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省科学技术厅项目（编号：2014A020212556）

摘　　要：【目的】运用循证医学方法评价浮针治疗膝关节骨性关节炎疗效的安全性与有效性。【方法】计算机系统检索Pub Med、Cochrane Library、EMabse、中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、中国生物医学文献光盘数据库(CBM)、万方资源数据库(Wanfang)中浮针治疗膝关节骨性关节炎的随机对照试验(RCT)及半随机对照试验(CCT)。由2名研究人员根据纳入标准和排除标准独立筛选、提取资料、质量评价并交叉核对,利用Cochrane系统评价文献质量,以RevMan5.3软件进行Meta分析。【结果】共纳入16项研究,涉及样本量1 367例,文献质量评价均为B级。Meta分析结果显示:试验组临床总有效率[OR=5.55,95%CI(3.59,8.58),P<0.000 01],愈显率[OR=4.86,95%CI(3.70,6.38),P<0.05],视觉模拟评分法(VAS)疼痛评分[MD=-0.78,95%CI(-1.11,-0.44),P<0.000 01],西安大略和麦克马斯特大学骨关节炎指数(WOMAC)[MD=-7.96,95%CI(-10.52,-5.40),P<0.000 01],膝关节损伤和骨关节炎评分(KOOS)[MD=8.96,95%CI(4.04,13.88),P=0.000 4]均优于对照组,差异均有统计学意义(P<0.05)。【结论】浮针治疗膝关节骨性关节炎具有较好的临床疗效,但由于纳入文献质量普遍不高,样本量有限,疗程与治疗次数不一,尚需更多严格设计、多中心、大样本的高质量随机对照试验结果来验证。Objective Evidence-based medicine method was used to evaluate the safety and effectiveness of floating needle therapy for the treatment of knee osteoarthritis(KOA). Methods The literature about randomized controlled trials(RCTs)and quasi-randomized controlled trials(CCTs)of floating needle therapy in treating KOA were derived from PubMed、Cochrane Library,EMabse,CBM,CNKI,VIP and Wanfang Database. And then two researchers screened out and extracted the data, evaluated the quality, and crosschecked the results according to the inclusion and exclusion criteria of the study,and used Cochrane system to evaluate the quality of literature and applied Rev Man 5.3 software for Meta-analysis. Results A total of 16 RCTs were included involving1 367 cases,and the overall quality of the literature is class B. Meta-analysis results showed that the total effective rate [OR = 5.55,95%CI(3.59,8.58),P < 0.000 01],the curative and markedly effective rate [OR = 4.86,95%CI(3.70,6.38),P < 0.05],visual analogue scale(VAS)pain score [MD =-0.78,95%CI(-1.11,-0.44),P <0.000 01],Western Ontario McMaster osteoarthritis index(WOMAC)[MD =-7.96,95%CI(-10.52,-5.40),P < 0.000 01] and knee injury and osteoarthritis outcome score(KOOS)[MD = 8.96,95%CI(4.04,13.88),P =0.000 4] in the test group were superior to those in the control group, and the differences were statistically significant(P < 0.05).Conclusion Floating needle therapy has an effect on treating knee osteoarthritis. However,due to the low quality, small sample size, inconsistence of treatment course with number of treatments in the included studies, more high-quality clinical trials with standardized methodology and a large sample size are needed to further confirm this consequence.

关 键 词：膝关节骨性关节炎 浮针 疗效 安全性 有效性 META分析 

分 类 号：R246.9[医药卫生—针灸推拿学]