补肾活血类中成药治疗膝骨性关节炎的有效性和安全性网状Meta分析  

Effectiveness and safety of Chinese patent medicines for reinforcing kidney and activating blood circulation in treatment of knee osteoarthritis:A network Meta-analysis

作　　者：尹润宇 杨东元 王世坤 李远栋[1] YIN Run-yu;YANG Dong-yuan;WANG Shi-kun;LI Yuan-dong(National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China)

机构地区：[1]天津中医药大学第一附属医院,国家中医针灸临床医学研究中心,天津300381

出　　处：《中草药》2023年第13期4266-4277,共12页Chinese Traditional and Herbal Drugs

基　　金：天津市中医中西医结合科研课题(2021105)。

摘　　要：目的运用网状Meta分析系统评价补肾活血类中成药治疗膝骨性关节炎(knee osteoarthritis,KOA)的有效性和安全性。方法运用计算机检索中、英文数据库包括中国知网(CNKI)、万方(Wanfang)、维普(VIP)、PubMed、Web of Science、Cochrane图书馆,搜索所有与补肾活血类中成药治疗KOA有关的随机对照试验(randomized controlled trial,RCT),时间限定为各库建库至2022年10月。基于频率学派使用Stata13.0和Review Manager 5.4软件进行分析。结果最终纳入37篇文献,涉及13种干预措施和3955例患者。系统分析结果表明:(1)在降低视觉模拟评分(visual analogue scale,VAS)方面,最好的前3种治疗方案为藤黄健骨类中成药+化学口服药(oral medicine,OM)、抗骨增生类中成药+OM、仙灵骨葆胶囊+OM;(2)在降低血清白介素-6方面,最好的前3种治疗方案是金乌骨通胶囊+OM、独活寄生丸+OM、抗骨增生类中成药+OM;(3)在降低血清肿瘤坏死因子-α方面,最好的前3种治疗方案是抗骨增生类中成药+OM、藤黄健骨类中成药+OM、金乌骨通胶囊+OM;(4)在不良反应发生率方面,安全性最高的前3种治疗方案是抗骨增生类中成药+OM、独活寄生丸、金乌骨通胶囊。结论在治疗KOA有效性方面,补肾活血类中成药联合OM效果较好,在安全性方面,最安全的治疗方案是抗骨增生类中成药+OM。受纳入的各种中成药研究质量及数量的限制,所得结论仍待更高质量的临床研究进一步验证。Objective To systematically evaluate the efficacy and safety of different Chinese patent medicines for reinforcing kidney and activating blood circulation in the treatment of knee osteoarthritis(KOA)by network Meta-analysis.Methods Chinese and English databases including CNKI,VIP,PubMed,Wanfang,Cochrane Library and Web of Science were searched by computer to gather randomized controlled trials(RCTs)on related Chinese patent medicines for reinforcing kidney and activating blood circulation in the treatment of KOA from their inception to October 2022.Based on frequentists,Stata13.0 software and Review Manager 5.4 were used for analysis.Results A total of 37 RCTs involving 13 interventions and 3955 patients eventually.The results of network Meta-analysis showed that:①In terms of reducing visual analogue scale(VAS)score,the optimal first three therapeutic schedule were Tenghuang Jiangu Chinese patent medicines(藤黄健骨类中成药)+oral medicine(OM),Kanggu Zengsheng Chinese patent medicines(抗骨增生类中成药)+OM,Xianling Gubao Capsule(仙灵骨葆胶囊)+OM;②In terms of reducing serum interleukin-6,the optimal first three therapeutic schedule were Jinwu Gutong Capsule(金乌骨通胶囊)+OM,Duhuo Jisheng Pill(独活寄生丸)+OM,Kanggu Zengsheng Chinese patent medicines+OM;③In terms of reducing serum tumor necrosis factor-α,the optimal first three therapeutic schedule were Kanggu Zengsheng Chinese patent medicines+OM,Tenghuang Jiangu Chinese patent medicines+OM,Jinwu Gutong Capsule+OM;④In terms of adverse reaction incidence,Kanggu Zengsheng Chinese patent medicines+OM,Duhuo Jisheng Pill,Jinwu Gutong Capsule may be the safest top three therapeutic schedule.Conclusion In the treatment of KOA,Chinese patent medicines for reinforcing kidney and activating blood circulation combined with OM has better effect.In terms of safety,Kanggu Zengsheng Chinese patent medicines+OM may be the safest treatment method.The conclusions of this study need to be further verified by higher quality studies due to the qua

关 键 词：膝骨性关节炎 中成药 补肾活血 网状Meta分析 金乌骨通胶囊 仙灵骨葆胶囊 壮骨关节类中成药 藤黄健骨类中成药 独活寄生丸 抗骨增生类中成药 

分 类 号：R285.64[医药卫生—中药学]