中成药治疗膝骨性关节炎的效果和安全性的系统评价  

A systematic review of efficacy and safety of Chinese patent medicines in knee osteoarthritis treatment

作　　者：吴迪 祁文[2] 张毅 谢旻成 陈跃平[1] 章晓云[1] WU Di;QI Wen;ZHANG Yi;XIE Min-cheng;CHEN Yue-ping;ZHANG Xiao-yun(Department of Orthopedics,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530011,China;Graduate School,Guangxi University of Chinese Medicine,Nanning 530001,China)

机构地区：[1]广西中医药大学附属瑞康医院骨科,南宁市530011 [2]广西中医药大学研究生院,南宁市530001

出　　处：《广西医学》2021年第19期2336-2349,共14页Guangxi Medical Journal

基　　金：国家自然科学基金(81760796);广西高校青年教师基础能力提升项目(2019KY0352);广西中医药大学校级科研课题(2019QN027,2020MS015);广西中医药大学一流学科课题(2019XK029)。

摘　　要：目的系统评价中成药治疗膝骨性关节炎(KOA)的效果和安全性。方法计算机检索中国知网、中国生物医学文献数据库、万方数据库、维普中文生物医学数据库,收集仙灵骨葆胶囊/颗粒、金天格胶囊、痹祺胶囊、盘龙七片和金乌骨通胶囊等中成药和常规方法治疗KOA的临床随机对照研究。筛选文献、提取数据和方法学质量评价后,采用R 3.6.1软件进行异质性检验和普通Meta分析,采用ADDIS 1.16.8软件进行网状Meta分析,绘制证据关系图,并进行统计分析及排序。结果本研究共纳入49个随机对照研究,包含5038例KOA患者。系统评价结果显示,单独或联合常规治疗KOA的有效率、缓解关节疼痛作用、改善膝关节功能作用均优于常规治疗(均P<0.05)。其中,在有效率方面,痹祺胶囊+常规治疗>痹祺胶囊>金乌骨通胶囊+常规治疗>仙灵骨葆胶囊/颗粒+常规治疗>金天格胶囊>盘龙七片>金天格胶囊+常规治疗>金乌骨通胶囊>常规治疗;在缓解关节疼痛方面,金乌骨通胶囊+常规治疗>盘龙七片>仙灵骨葆胶囊/颗粒+常规治疗>金乌骨通胶囊>金天格胶囊+常规治疗>痹祺胶囊+常规治疗>金天格胶囊>常规治疗>仙灵骨葆胶囊/颗粒;在改善膝关节功能方面,金天格胶囊+常规治疗>金天格胶囊>仙灵骨葆胶囊/颗粒+常规治疗>痹祺胶囊+常规治疗>金乌骨通胶囊+常规治疗>金乌骨通胶囊>常规治疗。金天格胶囊、金乌骨通胶囊、仙灵骨葆胶囊/颗粒+常规治疗安全性较常规治疗更好。结论中成药治疗KOA的疗效明显,安全性较好,采用痹祺胶囊+常规治疗可提高有效率,采用金乌骨通胶囊+常规治疗可缓解关节疼痛,采用金天格胶囊+常规治疗可改善膝关节功能。Objective To systematically evaluate the efficacy and safety of Chinese patent medicines in knee osteoarthritis(KOA)treatment.Methods A computer-based retrieval was conducted in databases such as Chinese National Knowledge Infrastructure,China Biology Medicine Disc,Wanfang Database,and VIP Chinese Scientific Journal Database to collect the clinical randomized controlled trials on the Chinese patent medicines,including Xianling Gubao Capsules/Granules,Jintiange Capsules,Biqi Capsules,Panlongqi Tablets and Jinwu Gutong Capsules,and conventional approaches for KOA treatment.After literature screening,data extraction and methodological quality evaluation,R 3.6.1 software was used to perform heterogeneity test and generic Meta-analysis,ADDIS1.16.8 software was employed to perform a network Meta-analysis,the evidence relationship diagram was developed,and statistical analysis and sorting were conducted.Results A total of 49 randomized controlled trials were enrolled in this study,including 5038 KOA patients.The results of systematic review showed that monotherapy or combined therapy was superior to conventional therapy for KOA in effective rate,efficacy for ameliorating knee pain,and efficacy for improving knee functions(all P<0.05).Wherein the effectiveness decreased in the sequence of Biqi Capsules+conventional therapy,Biqi Capsules,Jinwu Gutong Capsules+conventional therapy,Xianling Gubao Capsules/Granules+conventional therapy,Jintiange Capsules,Panlongqi Tablets,Jintiange Capsules+conventional therapy,Jinwu Gutong Capsules,and conventional therapy;the efficacy for ameliorating knee pain decreased in the sequence of Jinwu Gutong Capsules+conventional therapy,Panlongqi Tablets,Xianling Gubao Capsules/Granules+conventional therapy,Jinwu Gutong Capsules,Jintiange Capsules+conventional therapy,Biqi Capsules+conventional therapy,Jintiange Capsules,conventional therapy,and Xianling Gubao Capsules/Granules;the efficacy for improving knee functions decreased in the sequence of Jintiange Capsules+conventional therapy,Jintian

关 键 词：膝骨性关节炎 中成药 疗效 安全性 META分析 网状Meta分析 

分 类 号：R684.3[医药卫生—骨科学]