首页|补肾活血法治疗膝骨关节炎随机对照试验结局指标的现状分析

补肾活血法治疗膝骨关节炎随机对照试验结局指标的现状分析

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通过评价补肾活血法治疗膝骨关节炎(knee osteoarthritis,KOA)的临床随机对照试验(randomized controlled trial,RCT)结局指标的现状,为制定中医药治疗KOA核心指标集提供理论基础。检索中国知网(CNKI)、万方(Wanfang)、中国生物医学文献服务系统(SinoMed)、维普(VIP)、PubMed、EMbase、Cochrane Library、Web of Science 8 个数据库,以及ClinicalTrials。gov和中国临床试验注册中心,检索时限为建库至 2023 年 8 月,纳入主题为补肾活血法治疗KOA的RCT,2 名评价员进行文献筛选和数据采集,采用定性分析对结局指标进行总结。最终纳入 350 篇RCTs,涉及 165 种结局指标,累计出现频次 1 462次。指标可分为 6 个领域:症状/体征指标 23 种,出现频次 718 次,占 49。1%;中医症状/证候指标 3 种,出现频次 53 次,占3。6%;理化检查指标 130 种,出现频次 506 次,占 34。6%;生活质量评价指标 4 种,出现频次 20 次,占 1。3%;远期疗效指标 2种,出现频次 6 次,占 0。4%;安全性指标 3 种,出现频次 159 次,占 10。9%。此外,有 53 篇RCTs采用中医证候/症状积分作为疗效指标,使用了 8 种不同的测量工具。当前中医药采用补肾活血法治疗KOA的RCT存在诸多问题,如结局指标主次不分、测量工具多样、部分指标缺乏统一评判标准、使用不规范等,影响了研究的质量和可靠性。因此,建议借鉴国际经验,加强研究设计,将中医药的疗效特点与临床研究相结合,以构建适用于中医药特色的KOA核心指标集。
Status of outcome measures in randomized controlled trials of kidney-tonifying and blood-activating method in treatment of knee osteoarthritis
This study assesses the status of outcome measures in the randomized controlled trial(RCT)involving the kidney-tonif-ying and blood-activating method for treating knee osteoarthritis(KOA),aiming to establish a theoretical foundation for the develop-ment of a core set of outcome measures in traditional Chinese medicine(TCM)treatment of KOA.The relevant articles were retrieved from CNKI,Wanfang,VIP,SinoMed,PubMed,EMbase,Cochrane Library,and Web of Science,in addition to ClinicalTrials.gov and the China Clinical Trial Registration Center,with the time interval from inception to August 2023.The RCT of treating KOA with the kidney-tonifying and blood-activating method was included.Two assessors independently conducted literature screening,data col-lection,and qualitative analysis to compile the outcome measure results.A total of 350 RCTs were included,involving 165 outcome measures with the total frequency of 1 462.These outcome measures were categorized into six domains:symptom and sign measures(23)with the frequency of 718(49.1%),TCM symptom and syndrome measures(3)with the frequency of 53(3.6%),physical examination measures(130)with the frequency of 506(34.6%),quality of life measures(4)with the frequency of 20(1.3%),long-term efficacy measures(2)with the frequency of 6(0.4%),and safety measures(3)with the frequency of 159(10.9%).Ad-ditionally,53 studies used TCM syndrome and symptom scores as indicators of efficacy,employing eight distinct measurement tools.The RCTs involving the kidney-tonifying and blood-activating method for treating KOA had a variety of problems,such as unclear prio-ritization of outcome measures,diversity in measurement tools,absence of standardized assessment criteria for specific measures,and non-standardized usage.These problems affected the research quality and reliability.Hence,it is advisable to draw upon international expertise,improve research design,and merge TCM efficacy characteristics with clinical research to establish a core set of KOA out-come measures aligned with TCM principles.

knee osteoarthritiskidney-tonifying and blood-activating methodrandomized controlled trialoutcome measuresresearch statuscore outcome set

陈继鑫、周沁心、余伟杰、郭天赐、牛朴钰、叶云天、刘爱峰

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天津中医药大学 第一附属医院, 天津 300381

国家中医针灸临床医学研究中心, 天津 300381

绍兴市中医院, 浙江 绍兴 312000

膝骨关节炎 补肾活血法 随机对照试验 结局指标 研究现状 核心指标集

国家自然科学基金项目天津市卫健委津门医学英才项目中华中医药学会骨病防治交叉研究项目

81873316TJSJMYXYC-D2-0282023-GBJC-04

2024

中国中药杂志
中国药学会

中国中药杂志

CSTPCD北大核心
影响因子:1.718
ISSN:1001-5302
年,卷(期):2024.49(6)
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