膝外翻支具治疗膝骨性关节炎的荟萃分析  

Efficacy and safety of knee valgus brace in the treatment of knee osteoarthritis: a meta-analysis

作　　者：杨信信 李睿[1] 何良志 路凡 滕飞 耿彬[1] 盛晓赟[1] 夏亚一[1] YANG Xin-xin;LI Rui;HE Liang-zhi;LU Fan;TENG Fei;GENG Bin;SHENG Xiao-yun;XIA Ya-yi(Orthopaedic Department,The Second Hospital,Lanzhou Universityt Lanzhou 730000,China)

机构地区：[1]兰州大学第二医院骨科

出　　处：《中国矫形外科杂志》2019年第23期2158-2162,共5页Orthopedic Journal of China

基　　金：国家自然科学基金项目（编号：81874017和81672207）;兰州市科技计划项目（编号：2017-4-88和2018-3-52）;“中央高校基本科研业务费专项资金”重点研究基地创新项目（编号：lzujbky-2018-kb16和561219010）;兰州大学第二医院“院内博士科研基金”项目（编号：ynbskyjj2015-2-9）;兰州大学第二医院“萃英科技创新”计划项目（编号：CY2017-ZD02和CY2017-QN12）;甘肃省自然科学基金项目（编号：17JR5RA188）;甘肃省中医药管理局科研项目（编号：GZK-2017-51）

摘　　要：[目的]系统评价膝关节外翻支具治疗膝骨性关节炎的有效性和安全性。[方法]计算机检索PubMed、The Cochrane Library、Web of Science、CBM和CNKI数据库,收集膝关节外翻支具治疗膝骨性关节炎的研究,检索时限均为建库至2018年12月。由2名评价员独立筛选文献、提取数据并评价纳入研究的偏倚风险后,采用Stata/SE 14.0软件进行荟萃分析。[结果]共纳入7个RCT,包括627例患者。荟萃分析结果显示:与对照组相比,膝外翻支具不能改善KOOS疼痛评分[WMD=2.981,95%CI(-7.232,13.194),P=0.567],VAS疼痛评分[WMD=-0.650,95%CI(-3.304,2.003),P=0.631],KOOS-ADL评分[WMD=2.981,95%CI(-7.232,13.194),P=0.567]和WOMAC功能评分[WMD=-2.603,95%CI(-6.971,1.764),P=0.243],差异无统计学意义。[结论]当前证据显示膝关节外翻支具不能有效减轻膝关节炎疼痛、改善患者日常活动量和提高患膝功能,受纳入研究质量的限制,以上结论还需后续纳入更多高质量临床随机对照试验的荟萃分析进行验证。[Objective]To evaluate the effectiveness and safety of knee valgus brace in the treatment of knee osteoarthritis.[Methods]The PubMed,Cochrane Library,Web of Science,CBM and CNKI databases were searched and the RCTs about knee valgus brace for treatment of knee osteoarthritis were collected.Meta-analysis was performed using Stata/SE14.0 software after two independent reviewers screened the literatures,extracted the data and evaluated the risk of bias in the included studies.[Results]A total of 7 RCTs were included,involving 627 patients.Meta-analysis showed that knee valgus braces did not improve KOOS pain scores[WMD=2.981,95%CI(-7.232,13.194),P=0.567],VAS pain scores[WMD=-0.650,95%CI(-3.304,2.003),P=0.631],KOOS-ADL scores[WMD=2.981,95%CI(-7.232,13.194),P=0.567]and WOMAC functional scores[WMD=-2.603,95%CI(-6.971,1.764),P=0.243]compared with control groups,the differences were not statistically significant.[Conclusions]The current evidence shows that knee valgus brace can not effectively alleviate knee osteoarthritis pain,improve the daily activity of patients and improve knee function.Due to the limited quality of included studies,the above conclusions need to be verified by more high quality RCTs.

关 键 词：外翻支具 免载荷支具 膝骨性关节炎 荟萃分析 

分 类 号：R684.3[医药卫生—骨科学]