机构:[1]Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China 广东省中医院深圳市中医院深圳医学信息中心[2]Department of Orthopaedics, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China 大德路总院骨科广东省中医院[3]Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou 510130, China
Objective. To compare the efficacy and safety of kidney-tonifying and blood-activating medicinal herbs (KTBAMs) and nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of knee osteoarthritis (KOA). Methods. Randomized controlled trials (RCTs) from online databases that compared the efficacy of KTBAMs and NSAIDs in the treatment of KOA were retrieved. The main outcomes included the evaluation of functional outcomes, pain, and adverse effects. The Cochrane risk-of-bias (ROB) tool was used to assess methodological quality. Results. A total of 38 RCTs (3994 participants) were included in our meta-analysis. We found that KTBAMs had a significantly higher total effective rate (P<0.00001, risk ratio (RR) = 1.08, confidence interval (CI) = 1.05 to 1.11, I-2 = 4%) and a lower gastrointestinal adverse reaction rate (P<0.00001, RR = 0.36, CI = 0.24 to 0.53, I-2 = 33%) than NSAIDs. KTBAMs showed greater improvements in the Knee Society Scale (KSS) scores (mean difference (MD) = 7.17, 95% CI 0.71 to 13.64, P=0.03). Regarding the visual analog scale (VAS) scores, WOMAC scores, and Lequence scores, there were no significant differences between the KTBAM group and the NSAID group. The GRADE quality level of this systematic review indicated that the very low-quality evidence showed that KTBAMs had a higher total effective rate, while the moderate-quality evidence showed that the adverse reactions of KTBAMs were lower and the KSS scores were higher. Low-quality evidence showed no significant differences in improving VAS scores, WOMAC scores, or Lequence scores. Conclusion. KTBAMs were superior to NSAIDs in terms of a higher total effective rate, a lower adverse reaction rate, and a higher KSS score. There were no significant differences between KTBAMs and NSAIDs in improving VAS scores, WOMAC scores, and Lequence scores of patients with KOA. Therefore, KTBAMs may be an alternative effective method for treating KOA. However, high-quality, well-designed RCTs with long-term follow-up are still required.
基金:
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81873314, 81974574]; China Postdoctoral Science FoundationChina Postdoctoral Science Foundation [2018M633036]; Medical Science Research Foundation of Guangdong Province [B2019091]; Project of Guangdong Provincial Department of Finance [[2014]157, [2018]8]; Key Scientific Research Platforms and Research Projects of Universities in Guangdong Province [2018KQNCX041]; Science and Technology Research Project of Guangdong Provincial Hospital of Chinese Medicine [YN2019ML08, YK2013B2N19, YN2015MS15]
第一作者机构:[1]Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
通讯作者:
推荐引用方式(GB/T 7714):
Huang Hetao,Pan Jianke,Yang Weiyi,et al.Are Kidney-Tonifying and Blood-Activating Medicinal Herbs Better than NSAIDs for Knee Osteoarthritis? A Systematic Review and Meta-Analysis[J].EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE.2019,2019:doi:10.1155/2019/9094515.
APA:
Huang, Hetao,Pan, Jianke,Yang, Weiyi,Han, Yanhong,Luo, Minghui...&Liu, Jun.(2019).Are Kidney-Tonifying and Blood-Activating Medicinal Herbs Better than NSAIDs for Knee Osteoarthritis? A Systematic Review and Meta-Analysis.EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE,2019,
MLA:
Huang, Hetao,et al."Are Kidney-Tonifying and Blood-Activating Medicinal Herbs Better than NSAIDs for Knee Osteoarthritis? A Systematic Review and Meta-Analysis".EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019.(2019)