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...     

口服补肾活血方药联合关节腔注射玻璃酸钠治疗膝骨关节炎的Meta分析

目的:评价口服补肾活血方药联合关节腔注射玻璃酸钠治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法:应用计算机检索PubMed、Embase、The Cochrane Library、中国生物医学文献数据库、中国知网、万方数据库和维普网中关于口服补肾活血方药联合关节腔注射玻璃酸钠治疗KOA的随机对照试验文献,检索时限为建库至2020年7月31日。对照组采用膝关节腔注射玻璃酸钠注射液治疗,治疗组在对照组的基础上口服补肾活血方药,剂型不限。由2名研究人员独立检索、筛选文献,提取资料并评价纳入研究的偏倚风险。采用Revman5.3软件进行Meta分析。结果:共检索到1219篇文献,最终纳入24篇。Meta分析结果显示,治疗组的治疗有效率高于对照组[I²=0%,P=0.830;OR=5.29,95%CI(3.81,7.35),P=0.000];根据纳入研究中的方剂药物组成,将补肾活血方药分为补肾辅以活血、活血辅以补肾及补肾活血兼祛风湿3类,各亚组中治疗组的治疗有效率均高于对照组[补肾辅以活血:I²=0%,P=0.670;OR=5.98,95%CI(3.89,9.20),P=0.000。活血辅以补肾:I²=0%,P=0.770;OR=9.70,95%CI(3.24,29.04),P=0.000。补肾活血兼祛风湿:I²=0%,P=0.950;OR=3.32,95%CI(1.84,5.99),P=0.000)]。治疗组的膝关节疼痛视觉模拟量表评分低于对照组[I²=96%,P=0.000;MD=-1.30,95%CI(-1.81,-0.78),P=0.000]。治疗组的西安大略和麦克马斯特大学骨关节炎指数低于对照组[I²=97%,P=0.000;MD=-9.83,95%CI(-16.15,-3.51),P=0.002]。利用治疗有效率作发表偏倚分析,漏斗图显示各研究点分布基本对称,提示存在发表偏倚的可能性较小。结论:现有的证据表明,口服补肾活血方药联合关节腔注射玻璃酸钠治疗KOA的疗效优于单纯关节腔注射玻璃酸钠。     

针刀联合推拿治疗膝骨关节炎临床疗效的Meta分析

目的 系统评价针刀联合推拿治疗膝骨关节炎的临床疗效.方法 计算机检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学信息网(CBM)、PubMed、Cochrane图书馆中关于针刀联合推拿治疗膝骨关节炎的临床随机对照试验(RCT)的文献,对符合纳入标准的文献采用Cochrane评价手册5.1推荐的RCT质量评价...     

手法治疗膝骨关节炎疗效的系统评价

目的系统评价手法治疗膝骨关节炎的疗效。方弦检索中国期刊全文数据库（CNKI）、中国生物医学文献数据库、维普网（VIP）、PubMed、Cochranelibrary、EMbase数据库,收集国内外运用手法治疗膝骨关节炎的临床随机对照试验（RCT）,文献出版时间不限。由2名评价者根据有关的纳入和排除标准筛选文献,独立提取资料并进行质量评估,采用ReviewManager5．2软件进行Meta分析。结果共纳入5个随机对照试验,涉及451例病例。Meta分析显示：近期效果中,WOMAC指数变化量SDE.chenge=-9．59,95％ CI -15．53,-3．65 ,VAS变化量SDE.change=-16．64,95％CI -22．15,-11．12 ;远期效果中,WOMAC指数变化量SD e.change=-0．50,95％CI -0．79,-0．21 ,VAS变化量SDE.change=-8．29,95％C1 -15．70,-0．88 。结论手法治疗膝骨关节炎具有缓解膝骨关节疼痛、提高膝骨关节总体功能等作用,近期和远期疗效均良好。     

针刀与关节腔注射玻璃酸钠治疗膝骨关节炎疗效比较的系统评价和Meta分析

目的:评价针刀治疗膝骨关节炎的有效性和安全性。方法:计算机检索中国知网(CNKI)、维普数据库(VIP)、万方数据库(Wanfang Data)、PubMed和Cochrane临床对照试验中心注册库(2011年第3期),所有数据库检索时间从建库到2011年9月15日。纳入治疗组采用针刀疗法、对照组采用关节腔注射玻璃酸钠的随机对照试验,由2名评价者独立提取资料和评价文献质量后采用RevMan 5.1软件进行Meta分析。结果:共纳入6个随机对照试验,涉及429例患者。Meta分析结果显示针刀治疗膝骨关节炎的近期总有效率和治愈率均优于关节腔注射玻璃酸钠,其合并的OR值及95%CI分别为:OR=2.18,95%CI[1.17,4.06];OR=1.86,95%CI[1.21,2.85]。结论:针刀治疗膝骨关节炎近期疗效优于关节腔注射玻璃酸钠。但纳入试验方法学质量不高,且均未报道不良事件,建议开展高质量的随机对照试验加以验证。     

Injections of ginkgo in the treatment of cerebral infarction: a systematic review and network Meta-analysis

OBJECTIVE: To assess the clinical effectiveness and safety of injections of ginkgo(GI) combined with Western Medicine(WM) for cerebral infarction(CI).METHODS: Randomized controlled trials(RCTs) of CI treated by GI were searched in China National Knowledge Infrastructure Database, Wanfang, China Science and Technology Journal Database, Web of Science, Cochrane library, Embase, Pub Med and Chinese Biomedical Literature Database, with the publication data no later than April, 2016. The Cochrane risk of bias method was used to evaluate the methodological quality of the RCTs. The data were analyzed by Review Manager 5.3, Stata 13.0,and Win BUGS 14 software.RESULTS: Totally 37 RCTs involving 4330 patientswere included. By direct comparison, the results of GI group were significantly superior to the routine WM group in the total effective rates [OR = 3.61,95% CI(2.93, 4.44), P 0.0001], the neural function defect score(NFDS) [MD =-4.39, 95% CI(-5.47,-3.32), P 0.0001]. Network Meta-analysis(NMA)results showed that, between 5 GIs in efficacy, the difference comparing ginaton injections(Gb E) to ginkgo-dipyidamolum injections(GD) [OR = 1.74,95% CI(0.73, 3.65)], shuxuening injections(SXN)[OR = 1.06, 95% CI(0.609, 1.697)] or ginkgolides injections(GK) [OR = 4.711, 95% CI(1.178, 13.21)]reach statistical significance; the difference comparing GD to GK reach statistical significance [OR =2.791, 95% CI(0.866, 6.908)]; the difference comparing SXN to GK reach statistical significance[OR = 4.537, 95% CI(1.203, 12.41)]. Besides, there was no difference between 4 GIs in NFDS. Probability ranking result showed a great possibility for GK [Surface under the Cumulative Ranking curve(SUCRA) = 80.3%] in improving the total effective rates, which were followed by GD(SUCRA =73.34%), SXN(SUCRA = 46.59%), Gb E(SUCRA =45.46%), floium ginkgo extract and tertram ethypyrazine sodium chloride injections(FT)(SUCRA = 35.64%). However, GK(SUCRA = 80.3%) or Gb E(SUCRA = 69.4%) was better than other GIs in reducing NFDS.GK + WM is the best treatment measures to reduce NFDS in cerebral infarction,which were followed by SXN + WM(SUCRA =51.6%), GD + WM(SUCRA = 48.1%).CONCLUSION: GIs was more effectiveness on CI than the routine Western Medicine. But based on the limitations of the study, more high-quality randomized controlled trials will be necessary.     

茶碱联合噻托溴铵治疗稳定期慢性阻塞性肺疾病的Meta 分析

目的：系统评价茶碱联合噻托溴铵对稳定期慢性阻塞性肺疾病（COPD）患者肺功能及相关指标的影响,为临床提供循证参考。方法：计算机检索Cochrane图书馆、PubMed、EMBase、中国生物医学文献数据库、 CNKI、维普数据库和万方数字化期刊全文数据库中关于茶碱联合噻托溴铵治疗稳定期COPD患者的随机对照 试验（RCT）,根据纳入与排除标准进行筛选,提取资料后按照改良的Jadad 评分表评价文献质量,并采用 RevMan 5.2统计软件对相关指标进行统计分析。结果：共纳入20项RCT,合计1496例患者。Meta分析结果显 示, 茶碱与噻托溴铵联用可明显提升患者的第1秒用力呼气容积（FEV1）[SMD＝0.52,95%CI（0.33,0.71）,P < 0.001]、第1秒用力呼气容积占预计值百分比（preFEV1%）[MD＝5.05,95%CI（3.86,6.24）,P < 0.001]、第1秒用力 呼气容积与用力肺活量的比值（FEV1/FVC）[SMD = 0.70,95%CI(0.34,1.05）,P < 0.001]、用力肺活量（FVC） [MD = 0.21,95%CI（0.14,0.29）,P < 0.001]、深吸气量(IC）[MD = 0.33,95%CI（0.23,0.42）,P < 0.001],明显降低患 者的圣乔治呼吸问卷评分（SGRQ）[SMD = -0.96,95%CI（-1.35,-0.58）,P < 0.001]、mMRC评分[MD = -0.66,95% CI（-0.87,-0.44）,P < 0.001],差异均具有统计学意义;试验组6 min步行试验距离（6WMD）[SMD = 0.68,95%CI （-0.24,1.60）,P = 0.15]与再次入院时间[MD = -0.10,95%CI（-0.38,0.18）,P = 0.48]以及急性加重次数[SMD = - 0.36,95%CI（-0.74,0.02）,P = 0.06]与对照组相比,差异均无统计学意义。结论：茶碱与噻托溴铵联用可改善稳 定期COPD患者肺功能,减轻呼吸困难症状,且未增加不良反应发生率。     

温针灸与电针治疗膝关节骨性关节炎疗效比较Meta分析

目的 :评价比较温针灸与电针治疗膝关节骨性关节炎(KOA)的疗效。方法 :检索数据库,收集以电针为对照组的温针灸治疗KOA的临床随机对照试验,提取资料并进行方法学质量评估。采用Revman 5.3对纳入结果进行Meta分析。结果:11篇文献纳入研究,共772例患者。其治愈率合并汇总OR值为1.12,95%CI[0.76,1.65],其总有效率汇总OR值为1.21,95%CI[0.81,1.80],以上差异无统计学意义(P0.05),说明温针灸组与电针治疗KOA在治愈率和总有效率方面差异均无统计学意义。其中4篇使用骨性关节炎指数WOMAC的样本量为279,标准化均数差(SMD)的合并效应量为0.08,95%CI[-0.15,0.32];5篇以VAS为疼痛指标的样本量为339,SMD的合并效应量为0.25,95%CI[-0.11,0.61],以上差异均无统计学意义(P0.05),说明在以WOMAC评分为结局指标和使用VAS评分作为疗效指标时,温针灸与电针治疗KOA疗效比较差异无统计学意义。结论:温针灸治疗KOA疗效不优于电针。     

Efficacy of Chinese herbal medicine for lumbar disc herniation: a systematic review of randomized controlled trials

Objective

This is a review of the effects of Chinese herbal medicine (CHM) used alone to treat lumbar disc herniation (LDH).

METHORDS

A literature search of the following electronic databases from their inception to February 2013 was conducted: Chinese Biomedical databases, Chinese National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, Cochrane Library, Web of Science, MEDLINE, and EMBASE. Randomized controlled trials where CHM had been used to treat LDH were selected. Data extraction, quality assessment, and data analysis were carried out by two independent reviewers.

Results

Of the 2415 studies identified, eight with complete data on 1146 patients were selected. The methodological quality was poor in all trials. Five studies reported that CHM was better than Western Medicine [OR=2.81, 95% CI (1.27, 6.18); OR=3.34, 95% CI (1.92, 5.79); OR=2.22, 95% CI (1.08, 4.57); OR=6.67, 95% CI (1.34, 33.28); and OR=1.94, 95% CI (1.23, 3.06)]. Two studies reported that the clinical outcome was better in CHM groups than in physiotherapy and placebo groups, [OR=3.02, 95% CI (1.08, 8.46); and OR=2.67, 95% CI (1.26, 5.64), respectively], whereas one study reported no difference between CHM and physiotherapy groups. One study reported that CHM resulted in higher Japanese Orthopedic Association scores [MD=7.78, 95% CI (6.67, 8.89)] than in a control group and another that participants treated with CHM had lower Visual Analogue Scale scores [MD= − 0.72, 95% CI (− 0.86, − 0.58)] than those in a control group. Three studies reported that the adverse effects of CHM and Western Medicine did not differ significantly [OR=0.10, 95% CI (0.01, 1.85); OR=0.19, 95% CI (0.01, 4.07); and OR=0.07, 95% CI (0.00, 1.32)].

Conclusion

CHM may be more effective than other interventions for LDH; however, methodological weaknesses in the studies assessed in this review prevent a definitive conclusion. More high-quality large-scale studies are required to clarify this matter.     

从脾论治抑郁症临床疗效的Meta分析

目的:对从脾论治抑郁症的文献进行Meta分析,探讨其有效性和安全性.方法:检索中文期刊网全文数据库、万方科技信息数据库、中国生物医学文献数据库、中文维普科技期刊数据库、Cochrane library、 PubMed、Embase数据库,收集自建库至2020年1月6日从脾论治抑郁症的随机对照试验,对符合纳入标准的文献运...     

通心络胶囊对糖尿病性周围神经病变患者神经传导速度作用的系统评价

目的:评价通心络胶囊对糖尿病性周围神经病变患者神经传导速度作用的有效性。方法:计算机检索Cochrane图书馆临床对照试验资料库、Pubmed Embase、中国生物医学文献数据库、中国期刊全文数据库、万方期刊数据库等相关资料,按照Cochrane系统评价的方法,客观评价纳入研究的质量,提取有效数据,采用RevMan 5.2软件进行Meta分析。结果:共纳入14个随机对照试验,包括1 078例患者。结果显示,与对照组相比,通心络胶囊能进一步提高正中神经及腓总神经的运动神经传导速度[SMD=-1.10,95%CI(-1.54,-0.65),P0.01],[SMD=-1.83,95%CI(-2.35,-1.30),P0.01];提高正中神经及腓总神经的感觉神经传导速度[SMD=-1.27,95%CI(-1.80,-0.75),P0.01],[SMD=-1.60,95%CI(-2.39,-0.81),P0.01]。结论:通心络胶囊对糖尿病性周围神经病变患者神经传导速度作用是有效的。     

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。     

Effect and safety of stimulating acupoints in children with cough variant asthma:A Meta-analysis

OBJECTIVE:To evaluate the efficacy and safety of stimulating acupoints in subjects with childhood cough variant asthma(CVA).METHODS:A Meta-analysis of randomized controlled trials(RCTs) about the comparison between acupoint sticking therapy and non-acupoint sticking therapy for childhood CVA was conducted.The trials' quality and risk bias were assessed using the Cochrane Handbook tool.Odds ratio(OR) or risk ratio(RR) with 95% confidence intervals(CIs),mean differences(MDs) or standardized mean differences(SMDs) of a random-effects model were calculated.Heterogeneity was assessed by P value and I2 statistics.RESULTS:Thirteen studies were included in our review,indicating that the total effective rate of stimulating-acupoint group is better than that of control group [RR 1.19,95% CI(1.13-1.26),P 0.00001].The recurrence rate in two years [RR 0.31,95%CI(0.19-0.51),P 0.000 01] and cough duration[MD =-2.42,95% CI(-3.75,-1.09),P = 0.0004]of childhood CVA in stimulating-acupoint group were significantly lower than those in control group.Besides,stimulating acupoints can reduce the level of Ig E [SMD =-0.75,95% CI(-1.21,-0.30),P = 0.001] and EOS [SMD =-0.36,95% CI(-0.92,0.21),P = 0.22].CONCLUSION:Our findings suggest that stimulating acupoints had positive effects on childhood CVA and was relatively safe treatment.However,more RCTs with more useful indicators are warrant to confirm the current findings.     

Traditional Chinese Herbal Medicine for Perimenopausal Depression of Chinese Women: A Meta‑analysis

Objective: The objective of this study is to evaluate the effectiveness and safety of traditional Chinese herbal medicine (TCHM) in treatment of perimenopausal depression (PD) in China. Methods: To identify randomized controlled trials, an electronic search has been conducted through databases as follows: PubMed, the Cochrane Central Register of Controlled Trials, Web of Science, Chinese Biological Medicine Database, China National Knowledge Infrastructure Database, Chinese Scientific Journal Database, and WanFang Digital Periodicals Database. Methodological quality was evaluated by Cochrane Collaboration’s tool which is able to assess the risk of bias in Review Manager Software. What’s more, meta?analysis was performed by using Cochrane Collaboration’s RevMan 5.2 software, (Nordic Cochrane Centre, Cochrane Collaboration, Copenhagen, and Denmark). Dichotomous data were analyzed by using relative risk (RR) and 95% confidence interval (CI). Continuous variables were analyzed using weighted mean differences (WMDs) and 95% CI. Subgroup analysis was performed by the type of medicine which was used in the experimental group. Results: This meta?analysis includes 11 randomized control trials with 818 patients. Compared to the control group (RR: 1.14, 95% CI: [1.03, 1.26], P = 0.009 and WMD: ?2.09, 95% CI: [ ?3.58, ?0.18]), the experimental group had a significant higher clinical efficacy rate and relatively lower Hamilton Depression Rating Scale (HAM?D) score. For clinical efficacy rate, the results varied depending on the detail treatment measures of the experimental group. In the experimental group with TCHM, no significant difference was observed (RR: 1.14, 95% CI: [0.97, 1.33]), while in the experimental group combined with western medicine, a significant difference in the clinical efficacy rate between the experimental group and control group showed up (RR: 1.15, 95% CI: [1.01, 1.32], P = 0.04). For the HAM?D score, subgroup analyses revealed that the pure TCHM therapy was not associated with significant HAM?D score reduction compared to the control group (WMD: ?2.48, 95% CI: [?6.00, 1.03], P = 0.17). However, in the experimental group where western medicine was added to, the HAM?D score decreased statistically compared to the control group (WMD: ?1.88, 95% CI: [?3.58, ?0.18], P = 0.03). There is no serious adverse event in both groups. Conclusions: Combination therapy of TCHM and western medicine is more effective in treating PD in terms of clinical efficacy rate. However, the results should be interpreted with caution due to the mediocre methodological quality of the included trials.     

Effect of ultrasound-guided acupotomy vs electro-acupuncture on knee osteoarthritis:a randomized controlled study

OBJECTIVE:To investigate the effect of acupotomy on knee osteoarthritis(KOA),compared to electro-acupuncture(EA).METHODS:Sixty KOA patients were randomly divided into 2 groups:ultrasound-guided acupotomy group and EA group;each had 3 weeks' therapy.After the treatment,by contrast before and after therapy,by comparing curative effects among groups,we looked into disease improvement degree through activities of daily living score(ADL),hospital for special surgery index(HSS),visual analogue scales score(VAS) and knee joint's infrared thermal imaging detection.RESULTS:Graded by ADL,the excellent rate in acupotomy group was much higher than EA group;both acupotomy group and EA group had obviouschanges in HSS index before and after the therapy(P 0.01).And there was remarkable difference in HSS index variation between the groups(P 0.01).Acupotomy group and EA group showed big difference in pain index before and after treatment(P 0.01).Apparent difference also existed in the comparison among groups(P 0.01).Both acupotomy group and EA group had apparent changes in infrared thermal imaging detection before and after the treatment(P 0.01).CONCLUSION:Acupotomy and EA both have significant effects in KOA treatment;the former is better than the latter in relieving pain and improving knee functions.     

消癌平注射液联合铂类一线化疗方案治疗晚期非小细胞肺癌的Meta分析

目的 系统评价消癌平注射液联合铂类一线化疗方案治疗NSCLC的有效性及安全性.方法 计算机检索Cochrane Library、PubMed、CNKI、VIP、万方数据库、CBM、中医药在线等数据库,检索时限为各库建库时间至2012年9月,搜索消癌平注射液联合铂类一线化疗方案对比单纯铂类一线化疗方案治疗NSCLC的临床随机对照试验,试验中所采用的化疗方案都是以铂类为基础的三代化疗药物联合消癌平注射液,检索范围包括任何语言的文献,由两名评价者单独评价并交叉核对纳入研究标准后,采用RevMan5.1软件进行Meta分析.结果 共纳入10篇RCTs,Meta分析结果显示：与铂类一线化疗方案相比,消癌平注射液联合铂类一线化疗方案治疗NSCLC能提高患者近期疗效（OR=1.57,95%CI（1.12,2.20）,P=0.008）,可改善患者的生活质量（OR=3.19,95% CI（2.22,4.60）,P〈0.00001）;增强免疫功能,即提高NK细胞活性（SMD =6.03,95% CI（5.09,6.96）,P〈0.00001）、CD3^＋细胞活性（SMD=12.28,95% CI（11.29,13.27）,P〈0.00001）、CD4＋细胞活性（SMD=12.18,95% CI（11.41,12.95）,P〈0.00001）、CD8＋细胞活性（SMD=8.59,95% CI（7.84,9.34）,P〈0.00001）,但不能提高CD4^＋/CD8^＋水平（SMD=0.02,95% CI（-0.04,0.08）,P=0.48）;不良反应方面,消癌平注射液联合铂类一线化疗方案能减少血小板下降（RR=0.62,95% CI（0.40,0.97）,P=0.04）,同时虽然能减少白细胞下降,但无显著性差异（RR=0.60,95% CI（0.36,1.01）,P=0.05）,但不能减少血红蛋白下降（RR=0.67,95% CI（0.44,1.04）,P=0.07）;亦不能减轻恶心呕吐症状（OR=0.70,95% CI（0.37,1.33）,P=0.28）.结论 消癌平注射液联合铂类一线化疗方案治疗NSCLC能提高患者近期疗效,改善患者生活质量,增强患者免疫力,并能减轻血小板下降.然而,以上结果需要大样本的随机对照试验来进一步证实.     

加味当归四逆汤配合温针灸治疗膝骨性关节炎的随机对照研究

目的:评价加味当归四逆汤配合温针灸治疗膝骨性关节炎(OA)患者的临床疗效。方法:将95例膝骨性关节炎(OA)患者采用随机数字表法分为治疗组48例和对照组47例。治疗组服用加味当归四逆汤并配合温针灸治疗,对照组服用塞来昔布胶囊。2组均以1周为1疗程,治疗4个疗程后进行疗效评价。结果:治疗组总有效率为95.83%(95%CI=85.30%~99.46%);对照组为89.36%(95%CI=76.61%~96.42%);两组综合疗效比较(u=1.845 1,P=0.065 2),差异接近临界状态。两组治疗后VAS评分参数比较,差异无统计学意义。两组治疗后WOMAC评分比较(t=-4.566 4,P0.01),差异具有统计学意义。且两组在观察期间各项实验室检测指标均未见明显不良反应。结论:加味当归四逆汤配合温针灸治疗膝骨性关节炎优于塞来昔布的证据尚不够确定,其收益为OR=0.37(95%CI=0.07~1.96),NNT=16(95%CI=6.03~39.01)。     

朱氏一指禅推法联合电针治疗膝骨关节炎临床疗效观察

目的:对比朱氏一指禅推法联合电针与单纯电针治疗膝骨关节炎的疗效差异。方法:将100例入组患者随机分为观察组和对照组,观察治疗前、治疗3周后及治疗后3个月随访VAS评分、WOMAC量表评分及测量膝关节活动度(ROM)。结果:两组患者治疗3周后及治疗后3个月随访,VAS和WOMAC量表评分及膝关节活动度均较治疗前明显改善,差异有统计学意义(P<0.01);VAS评分两组间差异无统计学意义(P>0.05),观察组改善WOMAC量表评分及膝关节活动度均优于对照组,差异有统计学意义(P<0.01);观察组总有效率均优于对照组,差异有统计学意义(P<0.05)。结论:朱氏一指禅推法联合电针对膝骨关节炎治疗具有显著作用,尤其在改善关节僵硬、躯体功能障碍及恢复膝关节活动度方面更为明显。     

慢性阻塞性肺疾病合并慢性肺源性心脏病急性加重中医实证关联分析

目的:探讨高海拔环境下COPD合并慢性肺源性心脏病（CPHD）急性加重期中医实证与临床特征的相关性。方法:收集2016年12月－2017年11月青海省中医院肺病科COPD合并CPHD急性加重期253例住院患者的相关资料,进行中医辨证,采用多因素 logistic回归分析各证型与临床特征及所收集的所有实验室指...