摘要
目的 探讨富血小板血浆(PRP)关节腔内注射治疗膝骨性关节炎(KOA)相较于其他传统疗法的疗效与安全性。方法 通过计算机检索中国期刊全文数据库、中文期刊全文数据库、万方数据知识服务平台、中国生物医学文献数据库(CBM)、PubMed、Web of Science以及Cochrane Library等多个数据库,收集相关文献,为了确保文献的全面性和时效性,设定检索时间范围为各数据库建立至2024年8月。研究纳入已发表的随机对照试验(RCT),其中研究对象为KOA患者,试验组接受PRP关节腔内注射治疗,而对照组则接受其他保守治疗。对于纳入的RCT研究,采用Cochrane手册风险评估工具进行质量评价,并利用RevMan 5.4软件对结局指标进行Meta分析。结果 共纳入17篇相关文献,涉及1 237例患者,其中试验组650例,对照组636例,其中有49例患者分别使用左右两膝进行试验对照。Meta分析结果:与对照组相比,试验组总有效率较高[RR=1.16,95%CI(1.02~1.32),P=0.02];试验组治疗1个月后Lysholms评分[MD=11.73,95%CI(3.45~20.00),P=0.005],治疗6个月后视觉模拟评分(VAS)评分[MD=-1.07,95%CI(-1.71~-0.43),P=0.001]、西大略和麦克马斯特大学骨关节炎指数(WOMAC)评分[MD=-11.6,95%CI(-18.02~-5.30),P=0.000 3]均优于对照组。两组不良反应发生率差异无统计学意义[RR=0.94,95%CI(0.64~1.37),P=0.73]。结论 与其他传统疗法相比,采用PRP治疗可以提高患者的总体有效率,改善Lysholms评分、VAS评分、WOMAC评分,且安全性较高。
Objective To explore the efficacy and safety of intra-articular injection of platelet-rich plasma(PRP)in the treatment of knee osteoarthritis(KOA)compared with other traditional therapies.Methods Relevant literature was collected through computer searches of several databases,including China Knowledge Network(CNKI),Wanfang,Wipro,China Biomedical Literature Database(CBM),PubMed,Web of Science,and the Cochrane Library,etc.To ensure the comprehensiveness and timeliness of the literature,the search was conducted from the establishment of the respective databases until August 2024,which was the first year of the study.August 2024 to ensure the comprehensiveness and timeliness of the literature.Published randomised controlled trials(RCTs)were included in which patients with KOA were treated with PRP intra-articular injections in the experimental group and other conservative treatments in the control group.For the included RCT studies,the Cochrane Handbook Risk Assessment Tool was used for quality assessment and Meta-analysis of outcome indicators was performed using RevMan 5.4 software.Results A total of 17 relevant literatures were included,involving 1237 patients,including 650 in the experimental group and 636 in the control group,of which 49 patients were experimentally controlled using the right and left knees,respectively.Results of Meta-analysis:compared with the control group,the experimental group had a higher overall effective rate[RR=1.16,95%CI(1.02~1.32),P=0.02];the experimental group had a higher rate of Lysholmia after Lysholms score at 1 month[MD=11.73,95%CI(3.45~20.00),P=0.005];visual analogue score(VAS)in the experimental group at 6 months after treatment[MD=-1.07,95%CI(-1.71~-0.43),P=0.001],Western Ontario and McMaster University Osteoarthritis Index(WOMAC)score[MD=-11.6,95%CI(-18.02~-5.30),P=0.0003]were better than the control group.There was no statistically significant incidence of adverse reactions in both groups[RR=0.94,95%CI(0.64~1.37),P=0.73].Conclusion Compared with other traditional therapies,PRP treatment can improve the overall effective rate,improve the Lysholms score,VAS score and WOMAC score of patients,and has relatively high safety.
作者
邓淋城
余梁
谢正兴
宁众
万浩然
郑家宝
唐良华
DENG Lin-Cheng;YU Liang;XIE Zheng-Xing;NING Zhong;WAN Hao-Ran;ZHENG Jia-Bao;TANG Liang-Hua(Guizhou University of Traditional Chinese Medicine,Guiyang 550002,China;Department of Joint Orthopaedics,The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550001,China)
出处
《中国药物经济学》
2025年第7期81-88,共8页
China Journal of Pharmaceutical Economics
关键词
富血小板血浆
膝骨性关节炎
传统疗法
疗效
META分析
Platelet-rich plasma
Osteoarthritis of the knee
Traditional therapy
Efficacy
Meta-analysis
