Zhou Mingwang, Dong Zhuanli, Wei Changhao, Feng Lufang, Wang Xiaoping, Liu Haiping, J I Xing, Yang Kehu, L I Shenghua
{"title":"体外冲击波疗法联合透明质酸钠治疗膝骨关节炎的疗效和安全性：系统综述和 Meta 分析。","authors":"Zhou Mingwang, Dong Zhuanli, Wei Changhao, Feng Lufang, Wang Xiaoping, Liu Haiping, J I Xing, Yang Kehu, L I Shenghua","doi":"10.19852/j.cnki.jtcm.20231226.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy and safety of extracorporeal shockwave therapy (ESWT) combined with sodium hyaluronate (HA) for the treatment of knee osteoarthritis (KOA).</p><p><strong>Methods: </strong>PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang database, China Science and Technology Journal Database, and SinoMed were searched from inception to July 2020. The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews. The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis. The heterogeneity among the articles was evaluated using I2.</p><p><strong>Results: </strong>A total of 17 studies, comprising 2000 individuals, were included in this Meta-analysis. The results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with HA. Statistical analysis of clinical efficacy showed that [relative risk (<i>RR</i>) = 1.21, 95% confidence interval (<i>CI</i>) (1.12, 1.30), <i>P <</i> 0.01]. Statistical analysis of visual analog scale showed that [standardized mean difference (<i>SMD</i>) = －2.84, 95%<i>CI</i> (－4.01, －1.66), <i>P <</i> 0.01]. Western Ontario and McMaster University osteoarthritis index statistical analysis showed that [<i>SMD</i> = －1.57, 95% <i>CI</i> (－2.52, －0.61), <i>P <</i> 0.01]. Lysholm score statistical analysis showed that [<i>SMD</i> = 1.71, 95% <i>CI</i> (0.98, 2.44), <i>P <</i> 0.01]. In addition, only minor side effects, such as redness and swelling of the skin, were observed.</p><p><strong>Conclusions: </strong>Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive, well-tolerated, safe, and effective method to improve pain and functionality in patients with KOA. However, tightly controlled, randomized, large multicenter trials are warranted to validate the current findings.</p>","PeriodicalId":94119,"journal":{"name":"Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan","volume":"44 2","pages":"243-250"},"PeriodicalIF":0.0000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10927402/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy and safety of extracorporeal shock wave therapy combined with sodium hyaluronate in treatment of knee osteoarthritis: a systematic review and Meta-analysis.\",\"authors\":\"Zhou Mingwang, Dong Zhuanli, Wei Changhao, Feng Lufang, Wang Xiaoping, Liu Haiping, J I Xing, Yang Kehu, L I Shenghua\",\"doi\":\"10.19852/j.cnki.jtcm.20231226.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To assess the efficacy and safety of extracorporeal shockwave therapy (ESWT) combined with sodium hyaluronate (HA) for the treatment of knee osteoarthritis (KOA).</p><p><strong>Methods: </strong>PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang database, China Science and Technology Journal Database, and SinoMed were searched from inception to July 2020. The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews. The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis. The heterogeneity among the articles was evaluated using I2.</p><p><strong>Results: </strong>A total of 17 studies, comprising 2000 individuals, were included in this Meta-analysis. The results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with HA. Statistical analysis of clinical efficacy showed that [relative risk (<i>RR</i>) = 1.21, 95% confidence interval (<i>CI</i>) (1.12, 1.30), <i>P <</i> 0.01]. Statistical analysis of visual analog scale showed that [standardized mean difference (<i>SMD</i>) = －2.84, 95%<i>CI</i> (－4.01, －1.66), <i>P <</i> 0.01]. Western Ontario and McMaster University osteoarthritis index statistical analysis showed that [<i>SMD</i> = －1.57, 95% <i>CI</i> (－2.52, －0.61), <i>P <</i> 0.01]. Lysholm score statistical analysis showed that [<i>SMD</i> = 1.71, 95% <i>CI</i> (0.98, 2.44), <i>P <</i> 0.01]. In addition, only minor side effects, such as redness and swelling of the skin, were observed.</p><p><strong>Conclusions: </strong>Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive, well-tolerated, safe, and effective method to improve pain and functionality in patients with KOA. 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引用次数: 0
摘要
目的评估体外冲击波疗法（ESWT）联合透明质酸钠（HA）治疗膝骨关节炎（KOA）的有效性和安全性：方法：检索了PubMed、Embase、Cochrane图书馆、Web of Science、中国国家知识基础设施、万方数据库、中国科技期刊数据库和SinoMed从开始到2020年7月的数据。随机对照试验的质量由两名审稿人根据 Cochrane 协作系统综述的标准进行独立评估。然后使用 EndnoteX9 对确定的文章进行逐一筛选，以确定是否符合本 Meta 分析的条件。使用 I2 对文章之间的异质性进行评估：本次 Meta 分析共纳入了 17 项研究，涉及 2000 人。结果表明，根据 ESWT 联合 HA 的临床疗效，膝关节疼痛和功能均有明显改善。临床疗效统计分析显示[相对风险 (RR) = 1.21，95% 置信区间 (CI) (1.12, 1.30)，P 0.01]。视觉模拟量表的统计分析显示[标准化平均差（SMD）=-2.84，95% 置信区间（-4.01，-1.66），P 0.01]。西安大略和麦克马斯特大学骨关节炎指数统计分析显示[SMD = -1.57, 95%CI (-2.52, -0.61)，P 0.01]。Lysholm 评分统计分析显示[SMD = 1.71，95% CI (0.98，2.44)，P 0.01]。此外，只观察到皮肤红肿等轻微副作用：中低质量的证据显示，ESWT 联合 HA 是改善 KOA 患者疼痛和功能的一种廉价、耐受性好、安全且有效的方法。然而，要验证目前的研究结果，还需要进行严格对照、随机、大型多中心试验。
Efficacy and safety of extracorporeal shock wave therapy combined with sodium hyaluronate in treatment of knee osteoarthritis: a systematic review and Meta-analysis.
Objective: To assess the efficacy and safety of extracorporeal shockwave therapy (ESWT) combined with sodium hyaluronate (HA) for the treatment of knee osteoarthritis (KOA).
Methods: PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang database, China Science and Technology Journal Database, and SinoMed were searched from inception to July 2020. The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews. The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis. The heterogeneity among the articles was evaluated using I2.
Results: A total of 17 studies, comprising 2000 individuals, were included in this Meta-analysis. The results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with HA. Statistical analysis of clinical efficacy showed that [relative risk (RR) = 1.21, 95% confidence interval (CI) (1.12, 1.30), P < 0.01]. Statistical analysis of visual analog scale showed that [standardized mean difference (SMD) = －2.84, 95%CI (－4.01, －1.66), P < 0.01]. Western Ontario and McMaster University osteoarthritis index statistical analysis showed that [SMD = －1.57, 95% CI (－2.52, －0.61), P < 0.01]. Lysholm score statistical analysis showed that [SMD = 1.71, 95% CI (0.98, 2.44), P < 0.01]. In addition, only minor side effects, such as redness and swelling of the skin, were observed.
Conclusions: Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive, well-tolerated, safe, and effective method to improve pain and functionality in patients with KOA. However, tightly controlled, randomized, large multicenter trials are warranted to validate the current findings.
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