吉林大学学报(医学版) ›› 2015, Vol. 41 ›› Issue (03): 612-618.doi: 10.13481/j.1671-587x.20150334

• 临床研究 • 上一篇    下一篇

高渗葡萄糖局部注射治疗膝骨关节炎疗效的Meta分析

叶冬梅1, 陈琛2, 林紫薇3, 徐义明1, 白跃宏1   

  1. 1. 上海交通大学附属第六人民医院康复医学科, 上海 200233;
    2. 大连大学医学院解剖学教研室, 辽宁 大连 116021;
    3. 上海市第十人民医院内分泌与代谢科, 上海 200072
  • 收稿日期:2014-08-30 发布日期:2015-08-01
  • 通讯作者: 白跃宏,教授,主任医师,博士研究生导师(Tel:021-24058586,E-mail:aibyhw@126.com) E-mail:aibyhw@126.com
  • 作者简介:叶冬梅(1980-),女,上海市人,医学博士,主要从事骨关节疾病康复方面的研究。
  • 基金资助:

    上海市科委科技惠民项目资助课题(13231202600)

Meta-analysis on curative effect of dextrose prolotherapy for knee oteoarthritis

YE Dongmei1, CHEN Chen2, LIN Ziwei3, XU Yiming1, BAI Yuehong1   

  1. 1. Department of Rehabilitation, Affiliated Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China;
    2. Department of Human Anatomy, School of Medical Science, Dalian University, Dalian 116021, China;
    3. Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Shanghai 200072, China
  • Received:2014-08-30 Published:2015-08-01

摘要:

目的:利用Meta分析方法探讨高渗葡萄糖(高渗糖)膝关节局部注射(增生疗法)对膝骨关节炎(KOA)的治疗效果,为高渗糖注射治疗KOA提供理论依据。方法:利用PubMed、Scopus和the Cochrane Library等数据库检索关于高渗糖注射对KOA疗效的随机对照研究文献,按照循证医学系统的评价方法,逐一评价纳入研究的质量,提取有效的数据,采用RevMan 5.1软件对高渗糖注射组与对照组研究对象膝关节的疼痛、生理功能及僵硬等指标进行相关的Meta分析。结果:本研究共纳入5篇文献,共计355例患膝(234例患者)。Meta分析,高渗糖注射对KOA引发的疼痛有短期(SMD =-1.45,95% CI:-2.42~-0.48,P=0.003)及长期(SMD =-2.20,95% CI:-3.45~-0.94,P=0.000 6)缓解的效果。高渗糖局部注射可显著提高膝关节活动能力(SMD=-2.00,95% CI:-2.84~-1.55,P<0.00001),但对对膝关节僵硬程度无明显改善(SMD =-0.05,95% CI:-1.02~0.03,P=0.07)。结论:高渗糖注射可有效改善KOA患者疼痛及关节活动能力,但对改善膝关节僵硬效果尚不确切。

关键词: 高渗右旋葡萄糖, 增生疗法, 膝关节, 骨性关节炎, Meta分析

Abstract:

Objective To investigate the curative effect of dextrose used in knee osteoarthritis (KOA) by applying a Meta-analysis, and to provide evidence for dextrose prolotherapy of KOA. Methods The literatures about the effect of dextrose prolotherapy in the treatment of KOA were retrieved from Pubmed/Medline, Scopus the and Cochrane Library.All the related literatures were checked and qualified in the method of evidence-based medicine.The improvement of pain, physical function, and stiffness relief were analyzed by RevMan 5.1 between dextrose group and control group. Results Five case-control studies with a total of 355 knees from 234 patients were included.Meta-analysis showed that dextrose prolotherapy had both short-term and long-term effects on the pain relief(short term:SMD =-1.45, 95% CI:-2.42--0.48, P=0.003;long-term:SMD =-2.20, 95% CI:-3.45--0.94, P=0.000 6) in addition to physical function(SMD =-2.00, 95% CI:-2.84--1.55, P<0.000 01). The stiffness improvement was not significant(SMD =-0.05, 95% CI:-1.02-0.03, P=0.07). Conclusion For KOA, the dextrose prolotherapy could improve the symptoms of pain and physical function.But further studies are needed to exam its effects on stiffness.

Key words: dextrose, prolotherapy, knee joint, osteoarthritis, Meta-analysis

中图分类号: 

  • R684