目的 评价中药熏洗结合玻璃酸钠关节腔内注射治疗膝骨关节炎(knee osteoarthritis,KOA)的有效性与安全性.方法 检索万方数据库(Wanfang Data)、中国知网(CNKI)、维普网(VIP)、Cochrane Library、Embase以及Pub Med 6个数据库中公开发表的关于中药熏洗联合玻璃酸钠关节腔内注射治疗膝骨关节炎的随机对照试验,检索时限为建库至2022年12月31日,采用Cochrane干预系统评价手册对纳入文献进行质量评价,运用Rev Man 5.3软件对纳入文献进行Meta分析.结果 本研究共纳入16篇文献,总计1388例患者.Meta分析结果显示,与单纯使用玻璃酸钠关节腔内注射相比,联合中药熏洗治疗膝骨关节炎的有效率更高(RR=1.16,95%CI 1.11~1.21,P<0.00001),患者疼痛视觉模拟量表(VAS)评分更低(WMD=-0.64,95%CI-0.74~-0.53,P<0.00001),西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分(WMD=-6.81,95%CI-8.03~-5.59,P<0.00001)及 Lysholm 评分更高(WMD=4.71,95%CI 3.66~5.75,P<0.00001).结论 相比单独使用玻璃酸钠关节腔内注射治疗膝骨关节炎,联合中药熏洗可以提升疗效.
A Meta-analysis of fumigation of traditional Chinese medicine combined with intraluminal injection of sodium hyaluronate in the treatment of knee osteoarthritis
Objective To evaluate the efficacy and safety of fumigation with traditional Chinese medicine in the treatment of knee osteoarthritis(KOA).Methods Randomized controlled trials(RCTs)published in Wanfang Data,China Knowledge Network(CNKI),VIP,Cochrane Library,Embase and PubMed on the treatment of KOA by fumigation of traditional Chinese medicine com-bined with injection of sodium hyaluronate were retrieved,and the retrieval time was from December 31,2022.Cochrane intervention system evaluation manual was used to evaluate the quality of the included documents,and Rev Man 5.3 software was used to make a meta-analysis of the included documents.Results Sixteen articles were included in this study,with a total of 1388 patients.Meta-a-nalysis showed that compared with sodium hyaluronate injection alone,fumigation of traditional Chinese medicine combined with in-jection was more effective in the treatment of KOA(RR=1.16,95%CI 1.11~1.21,P<0.00001),patients'pain visual analogue scale(VAS)score was lower(WMD=-0.64,95%CI-0.74~-0.53,P<0.00001).Osteoarthritis Index(WOMAC)score(WMD=-0.64,95%CI-0.74~-0.53,P<0.00001)and Lysholm score(WMD=4.71,95%CI 3.66~5.75,P<0.00001)was high-er.Conclusion Compared with intra-articular injection of sodium hyaluronate alone in the treatment of KO A,fumigation with tradi-tional Chinese medicine can improve the curative effect.
fumigation and washing of traditional Chinese medicinesodium hyaluronateknee osteoarthritismeta-analysis