摘要
目的运用循证医学系统评价方法评价火针为主治疗膝关节骨性关节炎(KOA)的疗效与安全性,为临床实践和研究提供参考。方法计算机检索PubMed、EMBASE数据库、Web of science、Cochrane图书馆、中国期刊全文数据库、中文科技期刊全文数据库、中国生物医学文献数据库和万方数据库中关于火针治疗KOA的随机对照试验(RCT),检索时限均从建库至2013年8月。2名研究者按照纳入与排除标准独立进行文献筛选、资料提取、质量评价和交叉审核后,采用RevMan 5.2软件进行Meta分析。结果最终纳入8篇RCT,共820例患者。根据对照组治疗措施的不同进行亚组分析显示,与常规组比较,火针组治愈率[OR=2.12,95%CI(1.48,3.02)]、愈显率[OR=3.92,95%CI(2.65,5.81)]差异均有统计学意义(P<0.000 01);与温针组比较,火针组愈显率[OR=4.12,95%CI(1.92,8.87)]差异有统计学意义(P=0.000 3),治愈率[OR=3.09,95%CI(0.95,10.05)]差异无统计学意义(P=0.06);与毫针组(常规针刺和温针)比较,火针组治疗后关节疼痛积分[OR=-0.54,95%CI(-0.85,-0.24),Z=3.46]降低幅度差异有统计学意义(P=0.000 5)。在不良反应方面,未见火针治疗KOA的不良反应报告。结论现有临床证据表明,火针可以有效缓解KOA患者的临床症状,提高其生活质量。但其疗效优势尚需进一步研究,特别需要高质量、多中心、大样本的RCT来验证。
Objective To evaluate the effectiveness and safety of fire needle therapy for knee osteoarthritis （KOA）, and provide reference for clinic and research. Methods Systematic searches were conducted in PubMed, EMBASE, the Cochrane Library, Web of science, CNKI, VIP, CBM and WanFang Data to collect randomized controlled trials （RCTs） on fire needle therapy treating KOA from inception to August 2013. Two reviewers independently screened articles according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. Then meta-analysis was performed using RevMan5.2. Results A total of 8 RCTs involving 820 patients were included. According to the different measures of control groups, subgroup analyses was performed and meta-analysis results showed that compared with the routine acupuncture group, the fire needle therapy group in clinical cured rate [OR=2.12, 95% CI （1.48, 3.02）, P=0.000 1] and markedly effective rate （OR=3.92, 95%CI （2.65, 5.81）, P〈0.000 01] aspects all have statistical difference. Compared with the warm acupuncture group, the fire needle therapy group in the markedly effective rate [OR=4.12, 95% CI （1.92, 8.87）, P=0.000 3] is statistically significant, but there is no statistical difference between the two groups in clinical cured rate [OR=3.09, 95% CI （0.95, 10.05）, P =0.06]. Compared with the acupuncture needle （routine acupuncture and warm acupuncture） group, the fire needle therapy group in the visual analogue scale of knee pain [OR=-0.54, 95%CI （-0.85, -0.24）, Z=3.46, P=0.000 5] after treatment is statistically difference. The adverse reactions to fire needle treatment of KOA patients have not＆amp;nbsp;been reported. Conclusion Current clinical evidence indicates that fire needle therapy is efficient for relieving clinical symptoms of patients with KOA, and improving their quality of life. However, due to lack of enough high-quality studies, fire needle therapy has to be further studied by conducting more strictly-designed, multicenter and large-scale RCTs.
出处
《中国中医药信息杂志》
CAS
CSCD
2014年第5期10-14,共5页
Chinese Journal of Information on Traditional Chinese Medicine
