关节镜治疗痛风性关节炎有效性的系统评价

目的系统性评价关节镜清理术治疗痛风性关节炎的有效性。 方法计算机检索MEDLINE、EMBASE、CBM、CNKI、VIP及WangFang数据库(均为自建库至2015年)，收集有关关节镜和药物比较治疗痛风性关节炎病例的临床对照研究，对纳入研究的方法学质量进行评价，应用RevMan 5.0软件进行统计分析。 结果共纳入10项随机对照性研究，共409例患者，方法学质量多为B级。Meta分析结果显示，关节镜治疗(试验组)相对于药物保守治疗(对照组) [RR ＝ 1.43，95%CI 0.77，2.66，P＝0.26]优良率差异无明显意义。但两组术后VAS评分[MD＝1.96，95%CI －3.10，－0.82，P＝0.000 7]、Lysholm评分[MD＝5.64，95%CI 2.57，8.71，P＝0.000 3] 差异均有统计学意义(P <0.05)。 结论基于纳入文献的Meta分析结果，虽然两组间优良率差异无统计学意义(P> 0.05)，但两组术后VAS、Lysholm评分差异均有统计学意义(P<0.05)，关节镜清理术治疗痛风性关节炎与内科药物治疗相比具有一定优势。对临床治疗痛风性关节炎具有一定的参考性。

Efficacy of arthroscopic in the treatment of gout arthritis: a systematic review

ObjectiveTo evaluate the effectiveness of arthroscopic debridement for the treatment of gout arthritis. MethodsComputer retrieval of MEDLINE, EMBASE, CBM, CNKI, VIP and WangFang database (are building database to 2015) collected on arthroscopy and drug treatment, clinical control study of cases of gouty arthritis, into the method of quality evaluation, and using revman 5.0 software statistical analysis. ResultsA total of 10 randomized controlled studies were included, with a total of 409 patients, the quality of the method was B. The results of Meta analysis showed that the excellent rates of [RR=1.43, 95%CI 0.77, 2.66, P = 0.26] were not significantly different between the arthroscopic treatment group and the drug conservative treatment group. But the two groups of postoperative VAS score [MD=-1.96, 95%CI -3.10, -0.82, P = 0.000 7], Lysholm score [MD=5.64, 95%CI 2.57, 8.71, P=0.000 3] were statistically significant differences(P<0.05). ConclusionsBased on the Meta analysis results, although the excellent rate of the two groups was not statistically significant(P> 0.05), but the difference of VAS and Lysholm scores between the two groups was statistically significant(P<0.05), that arthroscopic debridement for treatment of gout arthritis and Department of internal medicine drug treatment group has a certain advantage. The above conclusions are of some reference to the clinical treatment of gout arthritis.