青藤碱制剂联合西药治疗膝骨关节炎疗效及安全性的Meta分析  

Efficacy and safety of sinomenine combined with western medicine in the treatment of knee osteoarthritis:a meta-analysis

作　　者：刘慧敏 吴清海 黄麟杰 陈富超 李春雷 LIU Hui-min;WU Qing-hai;HUANG Lin-jie(Department of Pharmacy,Dongfeng Hospital Affiliated to Hubei University of Medicine,Shiyan 442008,China.;不详)

机构地区：[1]湖北医药学院附属东风医院药学部 [2]湖北医药学院附属东风医院麻醉科,湖北十堰442008

出　　处：《中国处方药》2021年第10期8-11,共4页Journal of China Prescription Drug

基　　金：十堰市科技引导项目(18Y85);十堰市软科学计划项目(2019SS59)。

摘　　要：目的对口服或关节腔注射青藤碱制剂联合西药治疗膝骨关节炎(KOA)的临床疗效和安全性进行系统评价。方法在PubMed、Springer、Science Online、Cochrane Library、中国知网、万方数据库、维普数据库中计算机检索口服或关节腔注射青藤碱制剂联合西药治疗膝骨关节炎的随机对照试验(RCTs)。使用Revman 5.3软件进行Meta分析。结果共纳入13篇文献,1179例患者。Meta分析结果显示口服青藤碱制剂联合西药相对于单独使用西药治疗膝骨关节炎,能提高总有效率[OR=3.17,95%CI(2.04,4.94),P<0.0001];关节腔注射青藤碱制剂联合西药对有效率影响不明显[OR=1.63,95%CI(0.82,3.27),P=0.17];青藤碱制剂联合西药治疗能够改善WOMAC量表总积分、WOMAC疼痛、僵硬、关节功能障碍评分和VAS疼痛评分,未增加总不良反应发生率。结论口服青藤碱制剂联合西药治疗KOA能提高疗效,口服或关节腔注射青藤碱制剂联合西药治疗KOA安全性较好,但需更多高质量、多中心的RCTs来提升循证证据强度。Objective To evaluate the clinical efficacy and safety of oral or intra-articular injection of sinomenine combined with chemical drugs on knee arthritis(KOA).Methods RCTs of oral or intra-articular injection of sinomenine combined with chemical drugs on KOA were searched from PubMed,Springer,Science online,Cochrane Library,CNKI,Wanfang database and VIP database from the establishment of the database.The literature was analyzed by using Revman 5.3.Results A total of 13 articles including 1,179 patients were included.Meta-analysis showed that the efficacy of oral sinomenine preparations combined with chemical drugs was significantly superior than chemical drugs alone[OR=3.17,95%CI(2.04,4.94),P<0.0001],but the efficacy of intra-articular injection of sinomenine was similar to that of chemical drugs alone[OR=1.63,95%CI(0.82,3.27),P=0.17].The total score of WOMAC,pain,stiffness,joint dysfunction score and VAS score were significantly decreased.Combination thrapy of sinomenine preparations did not increase the incidence of total adverse reactions.Conclusion Combination therapy of oral sinomenine preparations on KOA is superior than using chemical drus alone.Oral or intra-articular injection of sinomenine preparation combined with chemical drugs on KOA are safe.However,high-quality and multi-center RCTs are necessary to support the clinical evidence.

关 键 词：青藤碱 膝骨性关节炎 疗效 META分析 

分 类 号：R684.3[医药卫生—骨科学]