针刀联合玻璃酸钠与单纯玻璃酸钠治疗膝骨关节炎疗效的Meta分析

目的：评价针刀联合玻璃酸钠膝关节内注射与单纯玻璃酸钠治疗膝骨关节炎（KOA）的临床疗疋。方法：以“Os-teoarthritis”“acupotomy”“needle-knife”“sodium hyaluronate”“膝骨性关节炎”“玻璃酸钠”“小针刀”等词语检索了Co-chrane Library（2013年第二期）及PubMed、CBM、CNKI、VIP、万方、中国生物医学期刊引文数据库，检索时间范围为各数据库建库至2013年05月20日。文献质量评价及RCT（随机对照试验）纳入由两个人员分别独立完成，使用CochraneLi-brary提供的RevMan5．2统计学软件进行数据分析。结果：共纳入7篇相关RCT总计583例病人纳入研究，分析结果显示：针刀联合玻璃酸钠膝关节内注射治疗KOA的短期疗优于单纯玻璃酸钠膝关节内注射（OR=4．18，95％CIE2．21，19．21]，Z=7．51，P〈0．00001）。结论：针刀联合玻璃酸钠膝关节内注射治疗KOA的短期疗优于单纯玻璃酸钠膝关节内注射。但是，鉴于纳入文献的质量较低，且均未记录不良事件，针刀联合玻璃酸钠治疗KOA的疗效是否优于单纯使用玻璃酸钠关节腔内注射尚有待于更多设计严谨的临床试验来论证。

Meta-analysis on Efficacy of Acupotomy combined with Sodium Hyaluronate versus Sodium Hyaluronate in Treating Knee Osteoarthritis

Objective：To assess the efficacy of acupotomy combined with sodium hyaluronate versus sodium hyaluronate a- lone for knee osteoarthritis （KOA）. Methods： Randomized,controlled trials （RCTs） of acupotomy combined with sodium hyaluronate versus only sodium hyaluronate in treating KOA were searched from CNKI, VIP, WanFang, PubMed, CBM and The Cochrane Central Register of Controlled Trials （Issue 2, 2013） with the deadline of retrieval may 20th, 2013. The Cochrane Collaboration＇s RevManS. 2 software was used for meta-analysis for the data which were extracted and evaluated by two reviewers independently. Results： Seven trials involving 583 patients in total were included. The meta-analyses showed that the efficacy of acupotomy combined with sodium hyaluronate was higher than simple sodium hyaluronate in short term （OR=4.18, 95%CI [-2.21, 19. 21], Z=7.51,P〈0. 00001）. Conelusion：Acupotomy combined with sodium hyaluronate is more effective than simple sodium hyaluronate in treating KOA in short term. However, most of the includ- ed studies are of low quality and no reports of adverse events are found, well-designed RCTs are still needed to further eval- uate the efficacy of acupotomoy combined with sodium hyaluronate.