针刺结合医用臭氧注射在膝骨性关节炎治疗作用中的系统评价

目的:系统评价针刺结合医用臭氧注射治疗膝骨性关节炎的临床疗效和安全性。方法:依据荟萃分析要求,全面检索CBM、CNKI、VIP、PubMed、Embase及TheCochraneLibrary等数据库,纳入以针刺结合医用臭氧注射为干预措施治疗膝骨性关节炎且为随机对照试验或临床对照试验的研究文献,文献的检索年限均为建库至2019年4月。由两名经过培训的研究人员独立进行检索并提取资料,如果遇到分歧,找第三方(老师或者专家)协助解决。采用Cochrane协作网提供的ReviewManager5.3软件进行数据的荟萃分析。结果:最终纳入15篇RCT或CCT,受试者共1244例,10篇文献报道总有效率,总有效率异质性检验:[Chi2=5.07,P=0.83,I2=0%,OR=4.00,95%CI(2.72,5.89),Z=7.03,P<0.00001]。10篇文献报道了VAS评分,异质性检验,[MD=-1.72,95%CI(-2.39,-1.06),Z=5.10,(P<0.00001)]。2篇文献报道了WOMAC指数,异质性检验,[Chi2=0.01,P=0.91,I2=0%,MD=-6.84,95%CI(-9.23,-4.45),Z=5.61,P<0.00001]。2篇文献报道了Lysholm膝关节功能评分,异质性检验,[Chi2=0.84,P=0.36,I2=0%,MD=7.97,95%CI(5.60,10.34),Z=6.60,P<0.00001]。仅有1篇文献报道不良反应的发生。结论:针刺结合医用臭氧注射治疗膝骨性关节炎疗效显著,易于推广,但其结论的验证还需要大样本高质量临床试验进一步验证。

Systematic Evaluation of Acupuncture Combined with Medical Ozone Injection in the Treatment of KOA

Objective:To systematically evaluate the clinical efficacy and safety of acupuncture combined with medical ozone injection in the treatment of knee osteoarthritis(KOA).Methods:According to the meta-analysis requirements,a comprehensive review were carried out from the databases of CBM,CNKI,VIP,PubMed,Embase and The Cochrane Library,randomized controlled trials(RCTs)or clinical controlled trials(CCTs)related to acupuncture combined with medical ozone injection in treating KOA.The review period was from the database establishment to April 2019.Two trained researchers independently searched and extracted information.If there was a disagreement,the third party(teacher or expert)was asked for help to solve the problem.A meta-analysis of the data was performed using Review Manager 5.3 software provided by the Cochrane Collaboration.Results:A total of 15 RCTs and CCTs were included,involving a total of 1244 subjects.Ten articles reported total effective rate,and total efficiency heterogeneity test was as follows:[Chi2=5.07,P=0.83,I2=0%,OR=4.00,95%CI(2.72,5.89),Z=7.03,P<0.00001].Ten papers reported VAS scores,heterogeneity tests was as follows:[MD=-1.72,95%CI(-2.39,-1.06),Z=5.10,(P<0.00001)].Two papers reported the WOMAC index,heterogeneity test was as follows:[Chi2=0.01,P=0.91,I2=0%,MD=-6.84,95%CI(-9.23,-4.45),Z=5.61,P<0.00001].Two literatures reported Lysholm knee function score,heterogeneity test was as follows:[Chi2=0.84,P=0.36,I2=0%,MD=7.97,95%CI(5.60,10.34),Z=6.60,P<0.00001].Only one document reported the occurrence of adverse reactions.Conclusion:Acupuncture combined with medical ozone injection is effective in treating KOA,and it is easy to be promoted.However,the conclusion needs further verification with large-scale and high-quality clinical trials in the future.