乌头汤联合治疗膝骨关节炎有效性与安全性的 Meta 分析
|
陈靓靓,袁文琪,张琰琳,潘长清,何歆怡,艾珏萍,莫小英,蒋荣云,刘啸天
|
1.长沙医学院，湖南长沙，410219；2.湖南中医药大学，湖南长沙，410208
|
摘要：目的：通过Meta分析方法系统评价乌头汤联合常规疗法治疗膝骨关节炎（Kneeosteoarthritis，KOA）的有效性与安全性。方法：计算机检索PubMed、MedLine、Embase、CochraneLibrary、WebofScience、中国知网、万方医学网、维普期刊等8个数据库，收集建库至2025年12月20日发表的相关文献。纳入乌头汤联合治疗KOA的随机对照试验（Randomizedcontrolledtrial，RCT），由两名研究员独立筛选文献、提取数据，并采用改良Jadad量表评估文献质量。使用Stata18.0和ReviewManager5.4软件进行Meta分析，通过异质性检验、敏感性分析和发表偏倚评估结果的稳健性。结果：共纳入7项RCT研究，总计1487例患者（观察组750例，对照组737例）。Meta分析显示，乌头汤联合治疗在提高治愈率（OR=3.22，95%CI：2.49～4.15，P＜0.001）和有效率（OR=3.72，95%CI：2.71～5.10，P＜0.001）方面显著优于对照组。异质性检验提示治愈率与有效率的研究异质性较低，敏感性分析结果稳健。漏斗图与Egger检验提示治愈率分析存在发表偏倚（P=0.008），有效率分析未发现明显发表偏倚（P=0.436）。结论：乌头汤联合治疗可显著提升膝骨关节炎的治愈率和有效率，且整体安全性良好，具有较高的临床应用价值。
关健词：膝骨关节炎；乌头汤；联合治疗；有效性；安全性；Meta 分析 |
Meta-analysis of the efficacy and safety of Wutau decoction in the treatment of knee osteoarthritis
|
Liangliang Chen,Wenqi Yuan,Yanlin Zhang,Changqing Pan,Xinyi He,Jueping Ai,iaoying Mo,Rongyun Jiang,Xiaotian Liu
1.Changsha Medical University，Changsha，Hunan，410219；2. Hunan University of Chinese Medicine，Changsha，Hunan，410208
|
Abstract：Objective：To evaluate the efficacy and safety of Wutai decoction combined with conventional therapy in the treatment of Knee osteoarthritis（KOA）by Meta-analysis. Methods：PubMed，MedLine，Embase，Cochrane Library，Web of Science，China National Knowledge Infrastructure（CNKI），Wanfang Medical Network，and VIP journals were searched by computer. Relevant articles published before December 20，2025 were collected. A Randomized controlled trial （RCT）of Wutau decoction combined with KOA was included. Two researchers independently screened the literature，extracted the data，and evaluated the quality of the literature by the modified Jadad scale. Meta-analysis was performed using Stata 18.0 and Review Manager 5.4 software，and the robustness of the results was evaluated by heterogeneity test，sensitivity analysis and publication bias. Results： A total of 7 RCTS involving 1487 patients（750 in the observation group and 737 in the control group）wereincluded. Meta-analysis showed that the combination of Wutau decoction was significantly better than the control group in improving the cure rate （OR=3.22，95%CI: 2.49-4.15，P < 0.001）and effective rate（OR=3.72，95%CI: 2.71-5.10，P < 0.001）. The heterogeneity test suggested that the heterogeneity of the cure rate and response rate was low，and the sensitivity analysis results were robust. Funnel plot and Egger test suggested that there was publication bias in the cure rate analysis （P=0.008），but no significant publication bias was found in the effective rate analysis （P=0.436）. Conclusion：The combined treatment with Wutou Decoction can significantly increase the cure rate and effective rate of knee osteoarthritis，and has overall good safety，with high clinical application value.
Keywords : Knee osteoarthritis；Wutau decoction；combination therapy；efficacy；safety；meta-analysis
参考文献
[1] 刘卓，熊诗丹，陈星，等.乌头散外敷治疗寒湿闭阻型膝骨关节炎的临床研究[J].中国民族医药杂志，2023，29（03）:26-27.
[2] 王玮莉，孙恒聪，黄金波，等.不同针药联合方案治疗阳虚寒凝型膝骨关节炎疗效观察[J].针灸临床杂志，2019，35（09）:30-33.
[3] 万峰格，邹吉锋，李桂云.乌头汤外用熏洗对寒证膝骨关节炎局部痛阈及皮温的影响[J].现代中西医结合杂志，2021，30（07）:759-762.
[4] Moher D，Shamseer L，Clarke M，et al. Preferred reporting items for systematic review and meta-analysis protocols （PRISMA-P）2015 statement[J]. Systematic Reviews，4（1）:1.
[5] Jadad AR，Moore RA，Carroll D，et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary[J]. Controlled Clinical Trials，17（1），1-12.
[6] 戴越保，周章武.加味乌头汤配合玻璃酸钠关节腔注射治疗膝骨性关节炎 24 例[J].湖南中医杂志，2013，29（09）:82-84.
[7] 鞠晓伟，罗宗键，吴晓光，等.乌头汤联合塞来昔布治疗风寒湿痹证膝关节骨性关节炎的临床观察[J].世界中西医结合杂志，2022，17（02）:346-349+353.
[8] 黎友允，刘晨峰，姚先秀，等.乌头汤治疗膝关节骨性关节炎的效果分析[J].中国当代医药，2013，20（21）:129-130.
[9] 孙有松，周爱芹，张涛.虫药五味乌头汤治疗膝骨性关节炎 395 例[J].河南中医，2011，31（10）:1144.
[10] 王诗康.乌头汤结合西药治疗膝骨性关节炎的疗效观察[J].基层医学论坛，2015，19（18）:2526-2527.
[11] 吴李秀，俞坤强，朱慧梅，等.筋针联合乌头汤治疗寒湿痹阻型早中期膝骨关节炎患者的临床疗效及其对血清 CTX-Ⅱ、COMP 的影响[J].中国现代医生，2021，59（22）:13-16.
[12] 郑倩仪，陈伯健.经方乌头汤配合电脑中频导入穴位治疗膝骨关节炎[J].实用医学杂志，2009，25（06）: 984-985. |
|
|
 |
论文收录证明 / 文献检索报告
Document Retrieval Certificate / Proof of Publication Indexing
作者贡献声明 / 贡献确认书
Author Contribution Statement / Certificate of Authorship Contribution
同行评审报告 / 评审意见
Peer Review Report / Peer Review Comments
利益冲突
Conflict of Interest
作者声明不存在任何利益冲突。
The author declares no conflict of interest.
|
