摘要
目的系统评价体外冲击波(ESWT)治疗膝骨性关节炎(KOA)的临床效果。方法检索PubMed、Embase、Web of Science、the Cochrane Library、CNKI、CBM、VIP、WanFang等数据库中有关ESWT治疗KOA的临床随机对照试验,检索时间为各数据库建库时间至2019年2月20日。2位研究者根据纳入和排除标准筛选文献,对纳入文献进行数据提取和质量评价,采用RevMan 5.3进行软件进行数据分析。结果共纳入11篇文献,969例患者。meta分析结果显示,ESWT组VAS评分低于对照组,差异有统计学意义(MD=-2.07,95%CI:-3.83,-0.31,P<0.05);ESWT组安大略西部和麦克巴斯特大学骨关节炎指数(WOMAC)明显低于对照组,差异有统计学意义(MD=-9.06,95%CI:-14.36,-3.76,P<0.01);两组间脱落率比较,差异无统计学意义(OR=0.82,95%CI:0.28,2.45,P>0.05)。亚组分析结果显示ESWT组VAS评分明显低于药物组,差异有统计学意义(MD=-1.99,95%CI:-3.58,-0.41,P<0.05);ESWT组VAS评分明显低于超声波组,差异有统计学意义(MD=-1.11,95%CI:-1.98,-0.23,P<0.05);ESWT组与玻璃酸钠组VAS评分比较,差异无统计学意义(MD=-2.86,95%CI:-9.23,-3.51,P>0.05)。结论ESWT可在短期内改善疼痛、僵硬和躯体功能。
Objective To systematically assess the clinical effect of extracorporeal shock wave therapy(ESWT)for knee osteoarthritis(KOA).Methods From the establishment of the database to February 20,2019,the databases of PubMed,Embase,Web of Science,the Cochrane Library,CNKI,CBM,VIP,WanFang were searched,and the clinical randomized controlled trials of ESWT in the treatment of KOA were searched.According to inclusion and exclusion criteria,the literature were screened with 2 researchers,the data and the quality of the included literature were extracted and evaluated.RevMan 5.3 was used for data analysis.Results A total of 11 articles,969 cases were included.The results of meta analysis showed that,VAS scores in ESWT group were lower than those in control group,with statistically significant differences(MD=-2.07,95%CI:-3.83,-0.31,P<0.05).Western Ontario and Mcmaster University Osteoarthritis index(WOMAC)in ESWT group were significantly lower than those in control group,with statistically significant differences(MD=-9.06,95%CI:-14.36,-3.76,P<0.01).There was no significant difference in shedding rate between the two groups(OR=0.82,95%CI:0.28,2.45,P>0.05).The results of the subgroup analysis showed that the VAS scores in ESWT group were significantly lower than those in drug group,with statistically significant differences(MD=-1.99,95%CI:-3.58,-0.41,P<0.05).VAS scores in ESWT group were significantly lower than those in ultrasonic group,with statistically significant differences(MD=-1.11,95%CI:-1.98,-0.23,P<0.05).VAS scores in ESWT group and sodium hyaluronate group showed no significant differences(MD=-2.86,95%CI:-9.23,-3.51,P>0.05).Conclution ESWT improves pain,stiffness,and somatic function in the short term.
作者
余绍涌
刘建航
周汉京
吴海波
谢桂鑫
李锦威
YU Shaoyong;LIU Jianhang;ZHOU Hanjing;WU Haibo;XIE Guixin;LI Jinwei(Graduate College,Guangxi University of Chinese Medicine,Guangxi Zhuang Autonomous Region,Nanning 530001,China;Department of Orthopaedics,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Guangxi Zhuang Autonomous Region,Nanning 530011,China;Yongkang Hall of Traditional Chinese Medicine,Hong Kong 999077,China)
出处
《中国医药导报》
CAS
2020年第3期69-73,I0004,共6页
China Medical Herald
基金
广西医疗卫生重点科研课题(重2012038)
广西壮族自治区教育厅科研课题(201204LX202)
广西科学研究与技术开发计划项目(2015BC12182)
广西中医药大学岐黄工程培育项目(030030001-04B1804804-500101)
关键词
体外冲击波
膝骨性关节炎
META分析
Extracorporeal shock wave therapy
Knee osteoarthritis
Meta analysis
作者简介
余绍涌(1994.11-),男,广西中医药大学研究生院2017级中医骨伤专业在读硕士研究生,研究方向:中医骨伤科学;通讯作者:刘建航(1976.7-),男,博士,主任医师,研究方向:中医骨伤科学。
