仙灵骨葆胶囊联合氨基葡萄糖治疗膝骨关节炎有效性和安全性的Meta分析

目的:系统评价仙灵骨葆胶囊联合氨基葡萄糖治疗膝骨关节炎(KOA)的有效性和安全性,为临床KOA的治疗提供循证参考。方法:计算机检索Cochrane图书馆、PubMed、Embase、中国知网、万方数据库、中国生物医学文献数据库和维普网,检索时限为各数据库建库起至2020年11月。收集在氨基葡萄糖(对照组)的基础上联用仙灵骨葆胶囊(试验组)治疗KOA的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取后,采用Cochrane 5.1.0系统评价员手册评价质量,并采用Rev Man 5.4软件进行Meta分析。结果:共纳入11项RCT,包括970例患者。Meta分析结果显示,试验组患者治愈率OR=2.41,95%CI(1.48,3.93),P<0.001]、显效率OR=1.95,95%CI(1.49,2.56),P<0.001]、总有效率OR=4.00,95%CI(2.57,6.24),P<0.001]、疼痛视觉模拟(VAS)评分MD=-2.34,95%CI(-2.51,-2.17),P<0.001]、膝关节功能评分MD=31.32,95%CI(27.89,34.75),P<0.001]、日本骨科协会(JOA)腰痛评分MD=12.22,95%CI(9.68,14.76),P<0.001]和疼痛缓解时间MD=-1.55,95%CI(-1.84,-1.25),P<0.001]方面均显著优于对照组,不良反应发生率显著低于对照组OR=0.04,95%CI(0.02,0.12),P<0.001]。结论:仙灵骨葆胶囊联合氨基葡萄糖治疗KOA在治愈率、显效率、总有效率、VAS评分、膝关节功能评分、JOA腰痛评分和疼痛缓解时间方面明显优于单独使用氨基葡萄糖,并可明显降低不良反应发生率。

Efficacy and Safety of Xianling Gubao Capsule Combined with Glucosamine in the Treatment of Knee Osteoarthritis:A Meta-analysis

OBJECTIVE:To systematically evaluate the efficacy and safety of Xianling gubao capsule combined with glucosamine in the treatment of knee osteoarthritis(KOA),and to provide evidence-based reference for clinical treatment of KOA.METHODS:Retrieved from Cochrane library,PubMed,Embase,CNKI,Wanfang database,CBM and VIP during the inception to Nov.2020,randomized controlled trials(RCTs)about glucosamine(control group)combined with Xianling gubao capsule(trial group)in the treatment of KOA were collected.After data extraction,Cochrane 5.1.0 system evaluator manual was used to evaluate the quality of the included clinical studies met inclusion criteria,and Rev Man 5.4 software was used for Meta-analysis.RESULTS:A total of 11 RCTs with 970 patients were included in this study.Results of Meta-analysis showed that cure rateOR=2.41,95%CI(1.48,3.93),P<0.001],marked effective rateOR=1.95,95%CI(1.49,2.56),P<0.001],total effective rateOR=4.00,95%CI(2.57,6.24),P<0.001],visual analogue scale(VAS)scoreMD=-2.34,95%CI(-2.51,-2.17),P<0.001],knee function scoreMD=31.32,95%CI(27.89,34.75),P<0.001],Japanese Orthopaedic Association(JOA)low back pain scoreMD=12.22,95%CI(9.68,14.76),P<0.001]and pain relief timeMD=-1.55,95%CI(-1.84,-1.25),P<0.001]of trial group were all significantly better than those of control group.The incidence of ADR in trial group was significantly lower than control groupOR=0.04,95%CI(0.02,0.12),P<0.001].CONCLUSIONS:Xianing gubao capsule combined with glucosamine in the treatment of KOA is significantly better in cure rate,marked effective rate,total effective rate,VAS,score,knee function score,JOA low back pain score and pain relief time,and could significantly reduce the incidence of ADR.