11种干预措施治疗膝骨关节炎的疗效评价

[目的]探讨奇正消痛贴，双氯芬酸二乙胺乳膏，双氯芬酸钠片，玻璃酸钠，针灸疗法，氨基葡萄糖片（胶囊），玻璃酸钠+针灸疗法，玻璃酸钠+中药熏洗法（饮片），玻璃酸钠+倍他米松，玻璃酸钠+臭氧，针灸+内服中药（饮片）治疗膝骨关节炎的有效性及安全性。[方法]计算机检索中国知网（CNKI）、万方（WF）、维普（VIP）、中国生物医学文献光盘数据库（CBMdisc）、Pubmed数据库，按纳入标准收集比较11种干预措施治疗膝骨关节炎的随机对照试验（RCT），提取资料并进行质量评价，采用R3.3.1软件进行网状Meta分析。[结果]纳入26项研究，共计3 484例患者。均为双臂研究，研究总臂数为54。网状Meta分析显示：11种干预措施均有效改善了膝骨关节炎的发生，疗效排第1位的是玻璃酸钠+臭氧疗法，其次是奇正消痛贴，依次类推，氨基葡萄糖胶囊疗效最差，这11种干预措施疗效差异具有统计学意义（P<0.05）。[结论]由分析结果可知，玻璃酸钠+臭氧疗法、奇正消痛贴、双氯芬酸钠片有效性相对好于其他干预措施，但由于纳入研究较少，受研究方法学质量限制，其药物疗效还需大样本、多中心、高质量RCT进一步证据验证。

Evaluation the efficacy of 11 kinds of interventions in the treatment of knee osteoarthritis

[Objective] Discussion Qizheng Xiaotong Paste, Diclofenac diethylamine cream diclofenac sodium tablets, Sodium hyaluronate, acupuncture, Glucosamine tablets (capsule), Sodium hyaluronate + acupuncture, Sodium hyaluronate + Herbal fumigation (Pieces), Betamethasone sodium hyaluronate, Sodium hyaluronate + ozone, Acupuncture + Chinese herb(pieces) treatment of knee osteoarthritis and safety.[Methods] Computer retrieval CNKI, Wanfang data (WF), VIP (VIP), Chinese biomedical literature database (CBMdisc), Pubmed, according to the inclusion criteria to collect more 11 kinds of interventions for the treatment of knee osteoarthritis randomized controlled trials (RCT), extract the data and quality evaluation, using R3.3.1 software to network meta-analysis.[Results] This research included in 26 studies, a total of 3484 patients. All studies were double arms study and the total arm number was 54. Network meta-analysis showed that 11 kinds of interventions are effective to improve the knee osteoarthritis occurs, the curative effect of sodium hyaluronate was chosen as the first plus ozone therapy, the second is Qizheng Xiaotong Paste and so on, glucosamine capsule curative effect is the worst, the 11 kinds of interventions efficacy differences statistically significant (P<0.05).[Conclusion] The analysis result shows that sodium hyaluronate + ozone therapy, Qizheng Xiaotong Paste, diclofenac sodium effectiveness is relatively better than other interventions, but due to less into research, being limited by the quality of research methodology, its efficacy still need large sample, multicenter, high-quality RCT evidence further validation.