温针灸治疗膝关节骨性关节炎Meta分析

目的:运用循证医学方法对温针灸(needle warming moxibustion,NWM)治疗膝关节骨性关节炎(knee osteoarthritis,KOA)的临床疗效进行系统回顾和Meta 分析.方法:检索国内外主要数据库查找相关文献并筛选治疗组为NWM 治疗,对照组为传统针刺(traditional acup...

A Meta Analysis of Warming Needle Acupuncture in the Treatment of Knee Osteoarthritis

Objective:To systematically review and carry out a Meta analysis of the clinical efficacy of warming needle moxibustion(WNM) in the treatment of knee osteoarthritis(KOA) by evidence-based medicine.Methods:The main databases at home and abroad were searched for relevant literatures,and the treatment group was selected as WNM treatment,while the control group was selected as traditional acupuncture(TA) or electroacupuncture(EA) treatment related clinical randomized controlled trials.The quality of the included pieces of literature was evaluated according to the Cochrane bias risk assessment standard,and the literature data were statistically analyzed by using the Review Manager 5.3 software.Results:A total of 17 articles including 1515 cases were included.Compared with EA,there were no significant differences in the effective rate [OR:0.91,95%CI(0.58,1.43),Z=0.41],WOMAC total score [WMD:0.98,95%CI(-1.76,3.71),Z=0.70],WOMAC functional activity score [WMD:2.22,95%CI(-3.94,8.38),Z=0.71] between WNM and EA(P>0.05).In the improvement of pain score [WMD:1.05,95%CI(0.31,1.79),Z=2.77],EA was better than WNM,and the difference was statistically significant(P<0.01).In the improvement of stiffness score [WMD:-1.28,95%CI(-2.11,-0.45),Z=3.02],WNM was better than EA,and the difference was statistically significant(P<0.01).Compared with TA,WNM was more effective in the treatment of KOA [OR:3.44,95% CI(2.25,5.27),Z=5.70],pain score [WMD:-1.61,95%CI(-1.96,-1.27),Z=9.19],Lysholm knee function score [WMD:17.36,95%CI(13.40,21.32),Z=8.60],WOMAC total score [WMD:-10.13,95%CI(-16.19,-4.07),Z=3.28],stiffness score [WMD:-8.01,95%CI(-13.39,-2.63),Z=2.92],functional activity score [WMD:-1.14,95%CI(-1.67,-0.61),ZA=4.18],ISOA index [WMD:-2.98,95%CI(-3.78,-2.18),Z=7.26],and all the differences were statistically significant(P<0.01).Conclusion:WNM is superior to EA in the treatment of KOA stiffness,and its effective rate,total WOMAC score and functional activity score are similar to those of EA.The effect of WNM on KOA,WOMAC total score,pain score,stiffness score,functional activity score,Lysholm knee function score and ISOA indexes were all better than those of TA.However,bias from other sources such as selectivity,measurement and double-blind may affect the results to a certain extent.Therefore,large sample size and high-quality RCTs are needed to verify this study.