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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
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