摘要
目的:系统评价中药汤剂联合关节镜治疗痛风性关节炎的疗效。方法:系统检索CNKI、CBM、WanFang、VIP、PubMed、Cochrane Library和EMBASE数据库,收据建库至2021年2月中药汤剂联合关节镜治疗痛风性关节炎的随机对照试验(RCTs),由2位研究者独立阅读题目与摘要进行筛选后阅读全文以明确是否纳入。采用Cochrane系统评价的方法对文献质量进行评估,采用RevMan 5.3软件对数据进行Meta分析。结果:最终纳入19篇RCTs,共计1383例患者,治疗组697例采用中药汤剂联合关节镜治疗,对照组686例采用单纯关节镜或联合西药进行治疗。Meta分析结果显示,治疗组的临床总有效率(P<0.00001)优于对照组。治疗组各个亚组的视觉模拟评分法(VAS)评分(P=0.0005、P<0.00001、P=0.03)以及红细胞沉降率(ESR)水平(P<0.00001、P<0.00001、P<0.00001)的降低均优于对照组。治疗组的Lysholm评分提高(P<0.00001、P<0.00001、P=0.19),血尿酸(UA)水平(P<0.00001、P=0.18、P<0.0001)及C反应蛋白(CRP)水平(P<0.0001、P<0.00001、P=0.23)的降低各有两个亚组优于对照组但均有一亚组比较并无明显差异。结论:中药汤剂联合关节镜治疗痛风性关节炎疗效确切,能更迅速缓解疼痛,改善关节功能,降低机体炎症及尿酸水平。但未来仍需要有样本量更大、设计更合理、质量更高的临床研究来论证本结论。
Objective:To systematically evaluate the efficacy of traditional Chinese medicine decoction combined with arthroscopy in the treatment of gouty arthritis.Methods:A systematic search of CNKI,CBM,WanFang,VIP,PubMed,Cochrane Library,and EMBASE databases,and the receipt of the database until February 2021. Randomized controlled trials(RCTs)of traditional Chinese medicine(TCM)decoction combined with arthroscopy in the treatment of gouty arthritis. Two researchers independently read the title and abstract to screen and them read the full text to clarify whether it should be included. The method of Cochrane systematic review was used to evaluate the quality of the literature,and the RevMan 5.3 software was used to conduct meta-analysis of the data. Results:Nineteen RCTs were finally included. A total of 1 383 patients,697 cases in the treatment group were treated with traditional Chinese medicine decoction combined with arthroscopy,and 686 cases in the control group were treated with arthroscopy alone or combined with western medicine. Meta-analysis results showed that the total clinical effective rate(P<0.000 01)of the treatment group was better than that of the control group. Visual analogue scoring(VAS)score(P=0.000 5,P<0.000 01,P=0.03)and erythrocyte sedimentation rate(ESR)level(P<0.000 01,P<0.000 01,P<0.000 01)reduction in each subgroup was better than that of the control group. The Lysholm score of the treatment group increased(P<0.00001,P<0.000 01,P=0.19),while for blood uric acid(UA)level(P<0.000 01,P=0.18,P<0.000 1)and C-reactive protein(CRP)levels(P<0.000 1,P<0.000 01,P=0.23)two subgroups were better than the control group,but there was no significant difference in one subgroup. Conclusion:Traditional Chinese medicine decoction combined with arthroscopy is effective in treating gouty arthritis,which can relieve pain,improve joint function,and reduce body inflammation and uric acid levels. However,in the future,clinical studies with larger sample sizes,more reasonable designs,and higher quality are still needed to demonstrate this conclusion.
作者
许卢春
王建军
叶超
王悦
李华南
XU Lu-chun;WANG Jian-jun;YE Chao;WANG Yue;LI Hua-nan(The First Clinical Medical College of Beijing University of Chinese Medicine,Beijing 100000,China;The Third Department of Orthopedics and Traumatology,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330000,China)
出处
《海南医学院学报》
CAS
2022年第23期1817-1828,共12页
Journal of Hainan Medical University
基金
国家自然科学基金项目(82060871、81860857)。
关键词
痛风性关节炎
中药
关节镜
疼痛
炎症
临床疗效
随机对照试验
META分析
Gouty arthritis
Traditional Chinese medicine
Arthroscopy
Pain
Inflammation
Clinical efficacy
Randomized controlled trial
Meta analysis
