针刀治疗股骨头坏死Meta分析  

Needle Knife Therapy for Osteonecrosis of the Femoral Head:A Meta-Analysis

作　　者：薛志鹏 李泰贤 孙继高 黄泽青 宋梦歌 贾朝旭 陈卫衡[1] XUE Zhipeng;LI Taixian;SUN Jigao;HUANG Zeqing;SONG Mengge;JIA Zhaoxu;CHEN Weiheng(Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]北京中医药大学,北京100029

出　　处：《辽宁中医药大学学报》2020年第5期78-83,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：北京市自然科学基金(7182186);“十二五”国家科技支撑计划(2015BAI04B03)。

摘　　要：目的系统评价针刀治疗股骨头坏死(Osteonecrosis of the Femoral Head,ONFH)的临床疗效。方法检索CNKI、WANFANG DATA、VIP、PubMed、Embase、Cochrane Library等数据库中关于针刀治疗股骨头坏死的随机对照试验。由2位作者严格按照纳入与排除标准,独立筛选文献,采用RevMan 5.3对纳入的研究进行Meta分析。结果共纳入16项研究,1389例患者。结果显示:(1)针刀单独应用:与保守治疗相比,针刀在改善Harris评分[MD=7.30,95%Cl(3.80,10.80),P<0.0001]、VAS评分[MD=0.91,95%Cl(0.57,1.25),P<0.00001]、临床有效率[RR=1.29,95%Cl(1.20,1.39),P<0.00001]方面更具优势,差异有统计学意义;与髓芯减压相比,针刀在改善Harris评分[MD=5.75,95%Cl(1.90,9.60),P=0.003]方面更具优势,差异有统计学意义。(2)针刀联合应用:与单独常规干预相比,针刀联合常规干预在改善Harris评分[MD=16.73,95%Cl(9.89,23.57),P<0.00001]、VAS评分[MD=2.97,95%Cl(2.52,3.41),P<0.00001]、临床有效率[RR=1.31,95%Cl(1.18,1.44),P<0.00001]方面更具优势,差异有统计学意义。结论不论与保守治疗还是髓芯减压相比,针刀治疗股骨头坏死具有一定的优势,且联合常规干预能增强临床疗效,值得推广应用。Objective To evaluate the efficacy of needle knife in the treatment of osteonecrosis of the femoral head(ONFH).Methods Databases including CNKI,WANFANG DATA,VIP,PubMed,Embase and Cochrane Library were searched to retrieve the clinical randomized controlled trials of needle knife for ONFH.According to the criteria of inclusion and exclusion,two authors independently screened the literature and used RevMan 5.3 software to perform meta-analysis on the included studies.Results A total of 16 studies including 1389 patients were included.The results showed that:(1)Needle knife alone application:compared with conservative treatment,needle knife had more advantages in improving Harris score[MD=7.30,95%Cl(3.80,10.80),P<0.0001],VAS score[MD=0.91,95%Cl(0.57,1.25),P<0.00001]and clinical effective rate[RR=1.29,95%Cl(1.20,1.39),P<0.00001],with statistically significant difference;compared with core decompression,needle knife had more advantages in improving Harris score[MD=5.75,95%Cl(1.90,9.60),P=0.003],with statistically significant difference.(2)Needle knife combined application:compared with conventional intervention alone,needle knife combined conventional intervention had more advantages in improving Harris score[MD=16.73,95%Cl(9.89,23.57),P<0.00001],VAS score[MD=2.97,95%Cl(2.52,3.41),P<0.00001]and clinical effective rate[RR=1.31,95%Cl(1.18,1.44),P<0.00001],with statistically significant difference.Conclusion Needle knife has certain advantages in treating ONFH compared with conservative treatment or core decompression,and the combination of needle knife and conventional intervention can enhance the clinical efficacy,which is worth promoting and applying.

关 键 词：针刀 股骨头坏死 随机对照试验 META分析 

分 类 号：R246[医药卫生—针灸推拿学]