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仙灵骨葆胶囊用于膝骨关节炎的系统评价再评价
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曹东东 1, 2* ,陈继鑫 ,余伟杰 ,郭天赐 ,张 宇 ,牛朴钰 ,刘爱峰 (1.天津中医药大学第一附属医院
骨伤科,天津 300381;2.国家中医针灸临床医学研究中心,天津 300381;3.绍兴市中医院骨伤科,浙江 绍兴
312000)
中图分类号 R969.3 文献标志码 A 文章编号 1001-0408(2025)02-0232-07
DOI 10.6039/j.issn.1001-0408.2025.02.17
摘 要 目的 对仙灵骨葆胶囊用于膝骨关节炎(KOA)的系统评价(SR)/Meta分析进行系统评价再评价,以期为该药的临床应用
提供循证支持。方法 检索中国知网、万方数据、维普网、中国生物医学文献数据库、the Cochrane Library、PubMed、Embase和Web
of Science,收集仙灵骨葆胶囊用于 KOA 有效性及安全性的 SR/Meta 分析,检索时限为建库至 2024 年 5 月 31 日。通过 PRISMA
2020声明、AMSTAR 2量表、ROBIS 工具和GRADE 工具分别进行报告质量、方法学质量、偏倚风险和证据质量评价,同时对SR/
Meta分析的定量结果进行综合质量分析。结果 共纳入5篇SR/Meta分析。PRISMA 2020声明评价结果显示,1项研究的信息相
对完整(21分),4项研究存在信息缺陷(18~20分);AMSTAR 2量表评价结果显示,5项研究的方法学质量均为极低级;ROBIS工
具评价结果显示,5 项研究的综合偏倚风险程度为“高风险”;GRADE 工具评价结果显示,49 个结局指标中,含中级证据 5 个
(10.2%)、低级证据12个(24.5%)、极低级证据32个(65.3%)。综合质量分析结果显示,仙灵骨葆胶囊联合常规治疗者的临床有效
率、视觉模拟评分法评分、疼痛缓解时间、膝关节功能综合指标、炎症因子水平及不良反应发生率均显著优于常规治疗者(P<
0.05)。结论 与常规治疗相比,仙灵骨葆胶囊联合常规治疗用于KOA可能具有一定的疗效和安全性优势。但由于纳入研究的结
局指标证据质量较低,因此所得结论需谨慎解读。
关键词 仙灵骨葆胶囊;膝骨关节炎;疗效;安全性;系统评价再评价
Reevaluation of systematic evaluation of Xianling gubao capsules for knee osteoarthritis
CAO Dongdong ,CHEN Jixin ,YU Weijie ,GUO Tianci ,ZHANG Yu ,NIU Puyu ,LIU Aifeng 1, 2
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(1. Dept. of Orthopedics and Traumatology, the First Teaching Hospital of Tianjin University of Traditional
Chinese Medicine, Tianjin 300381, China;2. National Clinical Research Center for Chinese Medicine
Acupuncture and Moxibustion, Tianjin 300381, China;3. Dept. of Orthopedics and Traumatology, Shaoxing
Hospital of Traditional Chinese Medicine, Zhejiang Shaoxing 312000, China)
ABSTRACT OBJECTIVE To conduct a reevaluation of the systematic review (SR)/meta-analysis on the use of Xianling gubao
capsules (XLGBC) for knee osteoarthritis (KOA), and provide evidence-based support for the clinical use of the drugs.
METHODS Computerized searches including CNKI, Wanfang Data, VIP, China Biomedical Literature Database, the Cochrane
Library, PubMed, Embase and Web of Science were conducted to collect systematic reviews (SR) or meta-analyses of XLGBC for
the treatment of KOA from the inception to May 31st, 2024. The report quality, methodological quality, risk of bias and evidence
quality were assessed using the PRISMA 2020 statement, AMSTAR 2 scale, ROBIS tool and GRADE tool, respectively. A
comprehensive quality analysis of the quantitative results from the SR/meta-analysis was also performed. RESULTS A total of five
SR/meta-analyses were included. The evaluation results based on the PRISMA 2020 statement showed that one study report was
relatively complete (21 points), while four studies had deficiencies (18-20 points). The assessment using the AMSTAR 2 scale
indicated that the methodological quality of all five studies was rated as very low. According to the ROBIS tool evaluation, the risk
of comprehensive bias in all five studies was classified as high. GRADE tool evaluation revealed that among 49 outcome indicators,
5 (10.2%) were rated as moderate-quality evidence (10.2%), 12 as low-quality evidence (24.5%), and 32 as very low-quality
evidence (65.3%). The results of comprehensive quality
Δ 基金项目 国家自然科学基金面上项目(No.82474538);天津市
科技计划项目(No.23KPXMRC00170);天津市卫生健康委第二批卫生 analysis showed that the clinical efficacy, visual analogue
健 康 行 业 高 层 次 人 才 选 拔 培 养 工 程 入 选 人 才 培 养 项 目(No. scale score, pain relief time, comprehensive indexes of knee
TJSJMYXYC-D2-028) joint function, the levels of inflammatory factors and the
*第一作者 博士研究生。研究方向:中西医防治骨与关节疾病。
incidence of adverse events in patients with XLGBC combined
E-mail:564117407@qq.com
# 通信作者 主任医师,博士生导师,博士。研究方向:中西医防治 with conventional treatment were significantly better than
骨与关节疾病。E-mail:draifeng@163.com conventional treatment alone (P<0.05). CONCLUSIONS
· 232 · China Pharmacy 2025 Vol. 36 No. 2 中国药房 2025年第36卷第2期