6种常用中成药联合非甾体抗炎药治疗膝骨关节炎的疗效和安全性的网状Meta分析  

Network Meta-analysis of Six Chinese Patent Medicines in Treatment of Knee Osteoarthritis

作　　者：郑仲洲 许东升 金秀均[3] 孙永生[2] ZHENG Zhongzhou;XU Dongsheng;JIN Xiujun;SUN Yongsheng(Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China;The Second Department of Orthopedics,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;Personnel Department,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中国中医科学院望京医院骨关节二科,北京100102 [3]中国中医科学院望京医院人事处,北京100102

出　　处：《药学与临床研究》2024年第4期338-342,共5页Pharmaceutical and Clinical Research

摘　　要：目的:采用网状Meta分析评价6种常用中成药(痹祺、金天格、金乌骨通、尪痹片、藤黄健骨、仙灵骨葆)联合非甾体抗炎药(NSAIDs)治疗膝骨关节炎(KOA)的疗效和安全性。方法:计算机检索数据库中有关6种常用中成药治疗KOA的临床随机对照研究(RCT),检索时限为各数据库建库至2023年10月31日。采用Cochrane推荐的偏倚风险评估工具对纳入的RCT进行质量评价。应用Stata 17.0进行网状Meta分析。结果:最终纳入19篇RCTs。结果显示,总有效率最优的前3种干预措施为痹祺+NSAIDs(87.7%)>金乌骨通+NSAIDs(79.8%)>尪痹片+NSAIDs(64%);降低视觉模拟评分(VAS)评分最优的前3种干预措施为金乌骨通+NSAIDs(72.8%)>仙灵骨葆+NSAIDs(64.2%)>藤黄健骨+NSAIDs(62.1%);降低骨关节炎指数(WOMAC)最优的前3种干预措施为藤黄健骨+NSAIDs(81.8%)>金天格+NSAIDs(80%)>仙灵骨葆+NSAIDs(53.1%);不良反应最少的前3种干预措施为藤黄健骨+NSAIDs(89.2%)>痹祺+NSAIDs(78.1%)>仙灵骨葆+NSAIDs(57%)。结论:中成药与NSAIDs联合应用可改善患者的临床治疗效果以及减少不良反应。Objective:To provide evidence based reference for the evaluation of efficacy and safety of combing six Chinese patent medicines(Bi-qi,Jin-tian-ge,Jin-wu-gu-tong,Wang-bi tablets,Teng-huang-jian-gu,Xian-ling-gu-bao)with NASIDs by network meta-analysis.Methods:PubMed,Cochrane Library,Web of Science,CNKI,Wangfang Data and CQVIP were retrieved to pick RCTs of Six Chinese patent medicines in the treatment of knee osteoarthritis from the date of construction to November 30,2023.The bias risk assessment tool recommended by Cochrane was used to evaluate the quality of the included RCTs.Results:Nineteen RCTs were included.The result showed that in terms of the overall efficacy,the optimal top three therapeutic schedules were Biqi+NASIDs,Jinwugutong+NASIDs and Wangbi tablets+NASIDs.In terms of visual analogue pain score,the optimal top three therapeutic schedules were Jinwugutong+NASIDs,Xianlinggubao+NASIDs and Tenghuangji-angu+NASIDs.In terms of WOMAC,the optimal top three therapeutic schedules were Ten-ghuangjiangu+NASIDs,Jintiange+NASIDs and Xianlinggubao+NASIDs.In terms of adverse reactions,the optimal top three therapeutic schedules were Tenghuangjiangu+NASIDs,Biqi+NASIDs and Xianlinggubao+NASIDs.Conclusion:Combination treatment of Chinese patent medicines and NASIDs can relieve symptoms caused by knee osteoarthritis and has better medical safety.

关 键 词：膝骨关节炎 中成药 网状Meta分析 

分 类 号：R684.3[医药卫生—骨科学]