瘀肾合治方药辅助治疗膝骨性关节炎的文献研究与分析

发布时间：2018-02-07 13:28

本文关键词： 瘀肾合治方药辅助治疗膝骨关节炎随机对照试验文献研究 Meta分析　出处：《中华中医药杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的:系统评价瘀肾合治方药辅助治疗膝骨性关节炎(KOA)的临床疗效及安全性。方法:计算机检索中国知网(CNKI)、维普(VIP)、万方及中国生物医学文献数据库及国外Pub Med、EMbase、MEDLINE、Cochrane Library等数据库;手工检索广州中医药大学图书馆馆藏期刊,检索时限截至2017年7月;搜集瘀肾合治方药辅助治疗KOA相关随机对照(RCT)研究文献。参照Cochrane系统评价方法进行文献筛选、资料提取及方法学质量测评;采用软件Rev Man 5.3进行Meta分析,并结合软件GRADEpro?GDT对本研究证据质量进行评价。结果:共纳入17项RCT研究文献,合计1 607例患者;Meta分析结果提示:(1)疗效评价:瘀肾合治方药辅助治疗KOA临床总有效率高于对照组;在骨性关节炎量表WOMAC总评分、疼痛、关节僵硬与生理功能评分以及肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、超敏C-反应蛋白(hs-CRP)等指标的改善方面均优于对照组(P0.01);(2)安全性评价:两组尚未存在严重不良反应事件报道;(3)证据分级:参考GRADE证据等级评估分析,本系统评价其测评级别提示"低质量或"极低质量"。结论:现有证据表明,瘀肾合治方药辅助治疗KOA疗效确切,不良反应较少,可以有效改善KOA症状;但由于本研究存在一定局限性,仍需高质量临床研究予以佐证。
[Abstract]:Objective: To evaluate the renal blood stasis treatment prescription of adjuvant treatment of knee osteoarthritis (KOA) clinical efficacy and safety. Methods: computer retrieval China HowNet (CNKI), VIP, Wanfang (VIP) and China biomedical literature database and foreign Pub Med, EMbase, MEDLINE, Cochrane Library database; manual retrieval Guangzhou University of Chinese Medicine library journals were searched by the end of July 2017; collecting blood stasis treatment prescription of adjuvant treatment of renal KOA related randomized (RCT) literature. According to the Cochrane system evaluation method of literature screening, data extraction and assessment of methodological quality; by using the software Rev Man 5.3 Meta analysis, combined with the software GRADEpro GDT to evaluate? In this study the quality of evidence. Results: 17 RCT studies were included, with a total of 1607 cases; Meta analysis showed that: (1) the curative effect evaluation: treatment of kidney blood stasis medicine auxiliary treatment of KOA clinical total Efficiency was higher than the control group; the pain in osteoarthritis scale, WOMAC score, joint stiffness and physiological function score, tumor necrosis factor alpha (TNF- alpha), interleukin -1 beta (IL-1 beta), high sensitive C- reactive protein (hs-CRP) as index were better than those of the control group (P0.01); (2) safety evaluation: two groups are not yet reported serious adverse events; (3): GRADE reference evidence grading evaluation and analysis level of evidence, the system of evaluation of the measurement level that "low quality or" low quality ". Conclusion: the available evidence suggests that blood stasis kidney treatment curative effect adjuvant treatment of KOA is effective, less adverse reaction, can effectively improve the symptoms of KOA; but since this study has some limitations, still need high quality clinical research evidence.

【作者单位】：广州中医药大学第二附属医院(广东省中医院);广州中医药大学第二临床医学院;广东省中医药科学院骨与关节退变及损伤研究团队;
【基金】：国家自然科学基金项目(No.81473698) 国家中医药管理局中医药标准化项目(No.SATCM-2015-BZ115,No.SATCM-2015-BZ173) 广东省财政厅项目(No.[2014]157号) 广东省中医院中医药科学技术研究专项(No.YN2015MS15,No.YN2018QN)~~
【分类号】：R274.9

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