浏览全部资源
扫码关注微信
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
博士研究生。研究方向:中西医防治骨与关节疾病。E-mail:564117407@qq.com
主任医师,博士生导师,博士。研究方向:中西医防治骨与关节疾病。E-mail:draifeng@163.com
纸质出版日期:2025-01-30,
收稿日期:2024-08-01,
修回日期:2024-12-16,
录用日期:2024-12-30
移动端阅览
曹东东,陈继鑫,余伟杰等.仙灵骨葆胶囊用于膝骨关节炎的系统评价再评价 [J].中国药房,2025,36(02):232-238.
CAO Dongdong,CHEN Jixin,YU Weijie,et al.Reevaluation of systematic evaluation of Xianling gubao capsules for knee osteoarthritis[J].ZHONGGUO YAOFANG,2025,36(02):232-238.
曹东东,陈继鑫,余伟杰等.仙灵骨葆胶囊用于膝骨关节炎的系统评价再评价 [J].中国药房,2025,36(02):232-238. DOI: 10.6039/j.issn.1001-0408.2025.02.17.
CAO Dongdong,CHEN Jixin,YU Weijie,et al.Reevaluation of systematic evaluation of Xianling gubao capsules for knee osteoarthritis[J].ZHONGGUO YAOFANG,2025,36(02):232-238. DOI: 10.6039/j.issn.1001-0408.2025.02.17.
目的
2
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
2
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
2
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
2
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。
OBJECTIVE
2
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
2
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
2
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 analysis showed that the clinical efficacy, visual analogue scale score, pain relief time, comprehensive indexes of knee joint function, the levels of inflammatory factors and the incidence of adverse events in patients with XLGBC combined with conventional treatment were significantly better than conventional treatment alone (
P
<0.05).
CONCLUSIONS
2
Compared with conventional treatment, XLGBC in combination with conventional treatment for KOA may have some efficacy and safety advantages. However, due to the low quality of evidence for the outcome indicators included in the studies, the conclusions should be interpreted with caution.
仙灵骨葆胶囊膝骨关节炎疗效安全性系统评价再评价
knee osteoarthritisefficacysafetyreevaluation of systematic review
YAO Q,WU X H,TAO C,et al. Osteoarthritis:pathogenic signaling pathways and therapeutic targets[J]. Signal Transduct Target Ther,2023,8(1):56.
SONG M,CHEN H J,LI J Y,et al. A comparison of the burden of knee osteoarthritis attributable to high body mass index in China and globally from 1990 to 2019[J]. Front Med,2023,10:1200294.
ANAM A K,INSOGNA K. Update on Osteoporosis screening and management[J]. Med Clin North Am,2021,105(6):1117-1134.
GBD 2021 Osteoarthritis Collaborators.Global,regional,and national burden of osteoarthritis,1990-2020 and projections to 2050:a systematic analysis for the global burden of disease study 2021[J]. Lancet Rheumatol,2023,5(9):e508-e522.
GIBBS A J,GRAY B,WALLIS J A,et al. Recommendations for the management of hip and knee osteoarthritis:a systematic review of clinical practice guidelines[J]. Osteoarthritis Cartilage,2023,31(10):1280-1292.
KOLASINSKI S L,NEOGI T,HOCHBERG M C,et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand,hip,and knee[J]. Arthritis Rheumatol,2020,72(2):220-233.
ARDEN N K,PERRY T A,BANNURU R R,et al. Non-surgical management of knee osteoarthritis:comparison of ESCEO and OARSI 2019 guidelines[J]. Nat Rev Rheumatol,2021,17(1):59-66.
郑勇,高建美,龚其海. 仙灵骨葆的药理作用和临床应用研究进展[J]. 中国新药与临床杂志,2018,37(1):1-5.
ZHENG Y,GAO J M,GONG Q H. Recent progress in study on pharmacological action and clinical application of Xianlinggubao[J]. Chin J N Drugs Clin Remedies,2018,37(1):1-5.
肖鸿智,李乐. 仙灵骨葆胶囊联合西药治疗膝骨关节炎的临床疗效及对血清炎症因子水平的影响[J]. 世界中西医结合杂志,2022,17(4):821-825.
XIAO H Z,LI L. Clinical efficacy of xianling gubao capsules combined with western medicine in treatment of knee osteoarthritis and effects on serum inflammatory factors[J]. World J Integr Tradit West Med,2022,17(4):821-825.
闫乾,陈锋,孙海林,等. 仙灵骨葆胶囊治疗膝骨性关节炎的有效性和安全性系统评价[J]. 中国药房,2014,25(35):3333-3338.
YAN Q,CHEN F,SUN H L,et al. Systematic review of the efficacy and safety of Xianling gubao capsules in the treatment of knee osteoarthritis[J].Chin Pharm,2014,25(35):3333-3338.
吴迪,祁文,张毅,等. 中成药治疗膝骨性关节炎的效果和安全性的系统评价[J]. 广西医学,2021,43(19):2336-2349.
WU D,QI W,ZHANG Y,et al. A systematic review of efficacy and safety of Chinese patent medicines in knee osteoarthritis treatment[J]. J Natl Prosec Coll,2021,43(19):2336-2349.
CUMPSTON M,LI T J,PAGE M J,et al. Updated gui-dance for trusted systematic reviews:a new edition of the Cochrane handbook for systematic reviews of interventions[J]. Cochrane Database Syst Rev,2019,10(10):ED000142.
HOCHBERG M C,ALTMAN R D,BRANDT K D,et al. Guidelines for the medical management of osteoarthritis: part Ⅱ:osteoarthritis of the knee:American College of Rheumatology[J]. Arthritis Rheum,1995,38(11):1541-1546.
PAGE M J,MCKENZIE J E,BOSSUYT P M,et al. The PRISMA 2020 statement:an updated guideline for repor-ting systematic reviews[J]. J Clin Epidemiol,2021,134:178-189.
SHEA B J,REEVES B C,WELLS G,et al. AMSTAR 2:a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions,or both[J]. BMJ,2017,358:j4008.
WHITING P,SAVOVIĆ J,HIGGINS J P,et al. ROBIS:a new tool to assess risk of bias in systematic reviews was developed[J]. J Clin Epidemiol,2016,69:225-234.
ATKINS D,BEST D,BRISS P A,et al. Grading quality of evidence and strength of recommendations[J]. BMJ,2004,328(7454):1490.
王粤淇. 仙灵骨葆胶囊治疗膝骨关节炎疗效的Meta分析及干预机制探讨[D]. 广州:广州中医药大学,2019.
WANG Y Q. Meta-analysis of curative effect of Xianling gubao capsule on knee osteoarthritis and discussion on intervention mechanism[D].Guangzhou:Guangzhou University of Chinese Medicine,2019.
李建垒,曹向阳,宋永伟. 仙灵骨葆胶囊治疗膝骨关节炎的Meta分析[J]. 中医临床研究,2020,12(20):143-148.
LI J L,CAO X Y,SONG Y W,A meta-analysis of trea-ting knee osteoarthritis with the Xianling gubao capsule[J]. Clin J Chin Med,2020,12(20):143-148.
郑子恢,张田,李琼,等. 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[J]. 中国药房,2021,32(7):870-875.
ZHENG Z H,ZHANG T,LI Q,et al. Efficacy and safety of Xianling gubao capsule combined with glucosamine in the treatment of knee osteoarthritis:a meta-analysis[J]. China Pharm,2021,32(7):870-875.
习文青. 仙灵骨葆胶囊治疗膝骨关节炎的Meta分析和网络药理学研究[D]. 北京:北京中医药大学,2022.
XI W Q. Meta-analysis and network pharmacology study on the treatment of knee osteoarthritis with Xianling gubao capsule[D]. Beijing:Beijing University of Chinese Medicine, 2022.
商岚清,周广智,程鑫雨,等. 仙灵骨葆胶囊针对膝骨关节炎疗效及安全性系统评价与荟萃分析[J]. 辽宁中医药大学学报,2024,26(4):132-139.
SHANG L Q,ZHOU G Z,CHENG X Y,et al. Systematic evaluation and meta-analysis of the efficacy and safety of Xianling gubao capsule in the treatment of knee osteoarthritis[J]. J Liaoning Univ Tradit Chin Med,2024,26(4):132-139.
0
浏览量
9
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构