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·循证药学·

        仙灵骨葆胶囊联合氨基葡萄糖治疗膝骨关节炎有效性和安全性

        的Meta分析            Δ


        郑子恢 ,张 田,李 琼,李文英,袁 华,张白鸽,马 琳,金鹏飞 [北京医院药学部/国家老年医学中心/中国医
                                                                   #
               *
        学科学院老年医学研究院/北京市药物临床风险与个体化应用评价重点实验室(北京医院),北京 100730]
        中图分类号 R684.3          文献标志码 A          文章编号 1001-0408(2021)07-0870-06
        DOI   10.6039/j.issn.1001-0408.2021.07.17
        摘   要   目的:系统评价仙灵骨葆胶囊联合氨基葡萄糖治疗膝骨关节炎(KOA)的有效性和安全性,为临床KOA的治疗提供循证
        参考。方法:计算机检索Cochrane图书馆、PubMed、Embase、中国知网、万方数据库、中国生物医学文献数据库和维普网,检索时
        限为各数据库建库起至2020年11月。收集在氨基葡萄糖(对照组)的基础上联用仙灵骨葆胶囊(试验组)治疗KOA的随机对照试
        验(RCT),对符合纳入标准的临床研究进行资料提取后,采用Cochrane 5.1.0系统评价员手册评价质量,并采用Rev Man 5.4软件
        进行 Meta 分析。结果:共纳入 11 项 RCT,包括 970 例患者。 Meta 分析结果显示,试验组患者治愈率[OR=2.41,95%CI(1.48,
        3.93),P<0.001]、显效率[OR=1.95,95%CI(1.49,2.56),P<0.001]、总有效率[OR=4.00,95%CI(2.57,6.24),P<0.001]、疼痛视觉
        模拟(VAS)评分[MD=-2.34,95%CI(-2.51,-2.17),P<0.001]、膝关节功能评分[MD=31.32,95%CI(27.89,34.75),P<
        0.001]、日本骨科协会(JOA)腰痛评分[MD=12.22,95%CI(9.68,14.76),P<0.001]和疼痛缓解时间[MD=-1.55,95%CI
        (-1.84,-1.25),P<0.001]方面均显著优于对照组,不良反应发生率显著低于对照组[OR=0.04,95%CI(0.02,0.12),P<0.001]。
        结论:仙灵骨葆胶囊联合氨基葡萄糖治疗KOA在治愈率、显效率、总有效率、VAS评分、膝关节功能评分、JOA腰痛评分和疼痛缓
        解时间方面明显优于单独使用氨基葡萄糖,并可明显降低不良反应发生率。
        关键词 仙灵骨葆胶囊;氨基葡萄糖;膝骨关节炎;有效性;安全性;Meta分析
        Efficacy and Safety of Xianling Gubao Capsule Combined with Glucosamine in the Treatment of Knee
        Osteoarthritis:A Meta-analysis
        ZHENG Zihui, ZHANG Tian, LI Qiong, LI Wenying, YUAN Hua,ZHANG Baige,MA Lin, JIN
        Pengfei [Dept. of Pharmacy,Beijing Hospital/National Center of Gerontology/Institute of Geriatric Medicine,
        Chinese Academy of Medical Sciences/Beijing Key Laboratory of Assessment of Clinical Drugs Risk and
        Individual Application(Beijing Hospital),Beijing 100730,China]

        ABSTRACT     OBJECTIVE: To systematically evaluate the efficacy and safety of Xianling gubao capsule combined with
        glucosamine in the treatment of knee osteoarthritis(KOA),and to provide evidence-based reference for clinical treatment of KOA.
        METHODS:Retrieved from Cochrane library,PubMed,Embase,CNKI,Wanfang database,CBM and VIP during the inception
        to Nov. 2020,randomized controlled trials(RCTs)about glucosamine(control group)combined with Xianling gubao capsule(trial
        group)in the treatment of KOA were collected. After data extraction,Cochrane 5.1.0 system evaluator manual was used to evaluate
        the quality of the included clinical studies met inclusion criteria,and Rev Man 5.4 software was used for Meta-analysis. RESULTS:
        A total of 11 RCTs with 970 patients were included in this study. Results of Meta-analysis showed that cure rate [OR=2.41,95%CI
        (1.48,3.93),P<0.001],marked effective rate [OR=1.95,95%CI(1.49,2.56),P<0.001],total effective rate [OR=4.00,95%CI
        (2.57,6.24),P<0.001],visual analogue scale(VAS)score [MD=-2.34,95%CI(-2.51,-2.17),P<0.001],knee function
        score [MD=31.32,95%CI(27.89,34.75),P<0.001],Japanese Orthopaedic Association(JOA)low back pain score [MD=
        12.22,95%CI(9.68,14.76),P<0.001] and pain relief time [MD=-1.55,95%CI(-1.84,-1.25),P<0.001] of trial group
        were all significantly better than those of control group. The incidence of ADR in trial group was significantly lower than control
        group [OR=0.04,95%CI(0.02,0.12),P<0.001]. CONCLUSIONS:Xianing gubao capsule combined with glucosamine in the
                                                            treatment of KOA is significantly better in cure rate,marked
            Δ 基金项目:国家自然科学基金资助项目(No.81303216);北京市            effective rate,total effective rate,VAS,score,knee function
        自然科学基金资助项目(No.7113164)                              score,JOA low back pain score and pain relief time,and
            *主管药师。研究方向:医院药学。电话:010-85136729。E-              could significantly reduce the incidence of ADR.
        mail:12686@qq.com                                   KEYWORDS     Xianling gubao capsule;Glucosamine;Knee
            # 通信作者:主任药师,博士。研究方向:医院药学。电话:010-                osteoarthritis;Effectiveness;Safety;Meta-analysis
        85133620。E-mail:j790101@163.com


        ·870 ·  China Pharmacy 2021 Vol. 32 No. 7                                    中国药房    2021年第32卷第7期
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