温针灸联合刺络放血干预膝骨性关节炎的Meta分析
A Meta-analysis of efficacy of warm acupuncture plus blood letting puncture on knee osteoarthritis
左泽慧 1魏琳 1龙景乾 2卢享君 3吕长姿 1陈成 3翟伟 3张衡才 3马文娟 3朱瑞欣 1迟静莹 1杜革术3
作者信息
- 1. 湖南中医药大学,湖南 长沙,410100
- 2. 贵州中医药大学,贵州 贵阳,550000
- 3. 长沙市中医医院,湖南 长沙,410100
- 折叠
摘要
目的:系统评价温针灸联合刺络放血对膝骨性关节炎的疗效及对患者膝关节疼痛症状改善与膝关节功能的影响.方法:检索中国知网、万方数据知识服务平台、PubMed、MedlineComplete等各大数据库,根据纳入与排除标准进行文献筛选.使用Review Manager 5.4.1 进行数据分析与绘制漏斗图、Cochrane偏倚风险测评工具进行发表偏倚风险评估,借助Stata 16.0 进行敏感性分析.结果:共纳入17项临床研究,患者总样本量为1 342例,包含试验组684例、对照组658例.Meta分析结果显示:①试验组的总有效率优于对照组,差异有统计学意义(P<0.000 01);②试验组在降低视觉模拟评分法(Visual Analogue Scale,VAS)评分、缓解膝关节疼痛方面优于对照组,差异有统计学意义(P<0.000 01);③在膝关节功能方面,试验组利斯霍姆膝关节功能评价量表(Lisholm Knee Function Score,Lysholm)评分提高水平优于对照组,西安大略和麦克马斯特大学骨关节炎指数量表(Osteoarthritis Index of Western Ontario and McMaster University,WOMAC)总评分降低水平优于对照组,奎森功能演算指数(Lequesne)评分降低水平优于对照组,差异均有统计学意义(P<0.000 01);④试验组无不良反应发生.结论:温针灸联合刺络放血干预膝骨性关节炎近期疗效确切,能有效缓解膝关节疼痛症状,改善膝关节功能,可初步认为该方法干预膝骨性关节炎具有安全性.鉴于纳入研究总体质量较低,仍须更多高质量随机对照试验予以验证.
Abstract
Objective:To systematically evaluate the efficacy of warm acupuncture plus blood letting puncture on knee osteoarthritis and its effects on the knee pain symptoms and knee function.Methods:CNKI,PubMed and other major databases were searched to screen literature according to inclusion and exclusion criteria.Data analysis and funnel plot mapping were performed by Review Manager 5.4.1.The publication bias assessment was performed by Cochrane bias risk assessment tool.A sensitivity analysis was given by Stata 16.0.Results:A total of 17 clinical studies were included,with a total sample size of 1 264 patients,including 632 cases in the trial group and 632 cases in the control group.The results of the Meta-analysis were listed below.①The total efficiency in the trial group was better than that in the control group,and the difference was statistically significant(P<0.000 01).②The trial group was better than the control group in reducing VAS score and alleviating knee pain,and the difference was statistically significant(P<0.000 01).③In terms of improving knee joint function,the amelioration of Lysholm score in the trial group was superior to that in the control group,the decrease of total WOMAC score in the trial group was superior to the control group,and the decrease of Lequesne score in the trial group was superior to that in the control group,with statistical significant differences(P<0.000 01).④ No adverse reactions occurred in the trial group.Conclusion:The effect of warm acupuncture plus blood letting puncture on knee osteoarthritis is definite in the near future.This therapy can effectively relieve the symptoms of knee pain and improve the function of the knee joint.It is preliminarily considered that this therapy is safe in the intervention of knee osteoarthritis.Given the low overall quality of the included studies,more high-quality randomized controlled trials are needed to confirm the above conclusion.
关键词
膝骨性关节炎/温针灸/刺络放血/疗效/Meta分析Key words
Knee osteoarthritis/Warm acupuncture/Blood letting puncture/Efficacy/Meta-analysis引用本文复制引用
基金项目
湖南省自然科学基金(2023JJ60075)
湖南省中医药科研项目(B2023113)
长沙市自然科学基金(2023CSSKJJ)
全国老中医药专家学术经验传承工作指导老师人才培养项目(第七批)(国中医药人教函[2022]76号)
湖南省中医药学科带头人人才培养项目(十四五)(湘中医药[2024]3号)
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据