尪痹制剂与非甾体抗炎药对比治疗膝骨关节炎的随机对照试验的系统评价

目的系统评价尪痹制剂与非甾体抗炎药治疗膝骨关节炎(KOA)的疗效及安全性。方法手工和在线检索尪痹制剂治疗KOA的随机对照试验文献,电子数据库包括中国期刊全文数据库(CNKI)、中国学术期刊数据库、中国生物医学文献数据库、中国科技期刊全文数据库、PubMed、Embase。依据纳入标准筛选合格研究并提取数据,采用Cochrane协作组评分方法行偏倚风险评估、方法学质量评价,Revman软件实施异质性检验、Meta分析、绘制倒置漏斗图等方法分析相关数据。结果纳入4篇临床研究文献,全部研究均报道了有效率及不良反应率,Meta分析结果显示,与非甾体抗炎药比较,尪痹制剂治疗OA有效率较高OR=5.76,95%CI(2.43,13.65),Z=3.97,P0.0001],且不良反应率较低OR=0.09,95%CI(0.03,0.25),P0.000001],但在改善关节疼痛方面,二者比较差异无统计学意义MD=-0.13,95%CI(-0.36,0.11),P=0.29]。尪痹制剂组红细胞沉降率(ESR)、C反应蛋白(CRP)均低于非甾体抗炎药组。结论基于目前证据,尪痹制剂可以有效治疗KOA,安全性较好,但鉴于较低的纳入研究质量以及本研究的局限性,目前证据尚难以得出较可靠的结论。

A systematic review of randomized controlled trials of Wangbi preparation compared with non-steroidal anti-inflammatory drugs for knee osteoarthritis

Objective To evaluate the efficacy and safety of Wangbi preparation and anti-inflammatory drugs and non-steroidal anti-inflammatory drugs (NSAIDs) on the treatment of knee osteoarthritis (KOA).Methods Randomized controlled trials (RCT) literatures of KOA were collected by manual and online, and the electronic database including Chinese Journal Full-text Database (CNKI), China Science Periodical Database, Chinese Biomedical Literature Database, Full-text Database of Chinese Sci-tech Journals, PubMed, Embase.We included all published clinical research accord with the inclusive criteria, the bias risk and methodological quality evaluation were evaluated through Cochrane collaborative group methods, the relevant data were analyzed by heterogeneity test of Revman software implementation, Meta-analysis, drawing inversion funnel map and,etc.Results Four clinical research literatures were eligible for inclusion.All reports included the effectiveness and adverse response rates.Meta-analysis showed that, compared with NSAIDs, Wangbi preparation had better effective rate of KOA OR=5.76, 95% CI (2.43, 13.65), Z=3.97, P<0.0001], with lower adverse reaction rate OR=0.09, 95% CI (0.03, 0.25), P<0.000001], but there was no statistical difference on improving joint pain MD=-0.13, 95% CI (-0.36, 0.11), P=0.29].The erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) in Wangbi preparation group were lower than those in NSAIDs group.Conclusion This systematic review offers support that Wangbi preparation has effective treatment for KOA, with high security.However, given the low inclusion quality of research and the limitations of this study, the current evidence is difficult to draw a more reliable Conclusion.