摘要
目的:系统评价针刀干预对膝骨关节炎(knee osteoarthritis,KOA)模型兔的影响,探讨针刀治疗KOA的可能的作用机制。方法:应用计算机检索中国知网、万方数据库、维普网、中国生物医学文献服务系统、PubMed、Web of Science、Cochrane Library、Embase,收集针刀干预KOA模型兔的随机对照动物实验,检索时限均为建库至2022年10月21日。实验组采用针刀疗法干预,对照组不进行任何干预。由2名研究者独立筛选文献、提取数据并评价纳入研究的偏倚风险,采用RevMan5.3软件进行Meta分析。采用STATA14.0软件进行Bgger’s检验,评价发表偏倚。结果:最终纳入17项研究,涉及258只KOA模型兔,实验组和对照组各129只。Meta分析结果显示,针刀干预后实验组的Lequesne MG评分、Mankin评分、软骨细胞凋亡率、关节液白细胞介素(interleukin,IL)-6表达水平、关节液肿瘤坏死因子-α表达水平均低于对照组[MD=-3.05,95%CI(-4.05,-2.05),P=0.000;MD=-3.95,95%CI(-4.86,-3.04),P=0.000;SMD=-3.81,95%CI(-5.79,-1.84),P=0.000;SMD=-1.99,95%CI(-2.83,-1.16),P=0.000;SMD=-4.22,95%CI(-7.43,-1.01),P=0.010],2组关节液IL-1表达水平的差异无统计学意义[SMD=-22.98,95%CI(-64.60,18.65),P=0.280]。基于Mankin评分进行发表偏倚分析,Bgger’s检验显示不存在发表偏倚(P=0.074)。结论:现有的证据表明,针刀干预能够减轻KOA模型兔膝关节疼痛与肿胀、改善膝关节功能和软骨组织病理学形态,其作用可能与减少软骨细胞凋亡、抑制相关促炎症细胞因子表达有关。
Objective:To systematically review the effects of acupotomy intervention on model rabbis with knee osteoarthris(K0A),and to explore the poss ible mechanisms of acupotomy in trealment of KOA.Methods:All the articles about intervention on KOA model rmab-bits with acupotomy included from database establishing to October 21,2022 were retrieved from China National Knowledge Internet,Wan-fang Database,Vip Database,Chinese Biomedical Literature Service System,PubMed,Web of Science,Cochrane Library and Embase through computer.The rabbits in experiment group were intervened by acupotony therapy,while the ones in control group were not given any intervention.The articles were screened and the information was extracted independenly by two researchers.The risk of bias of included re searches was assessed and a Meta-analysis was conducted by using RevMan5.3 software.F urthermore,the Bgger's test was performed by using STATA 14.0 software,and the publication bias was evaluated.Results:Seventeen articles(258 K0A model rabbits)were included in the final analysis,129 K0A model rabbts in each group.The results of Meta-analysis revealed that the Lequesne MG score,Mankin score,chondrogyte apoptos is rale,the express ion levels of intereukin(IL)-6 and tumor necrosis factor-a in knee synovial fluid were all lower in ex-periment group compared to control group afer acupotomy intervention(MD=-3.05,95%CI(-4.05,-2.05),P=0.00;MD=-3.95,95%CI(-4.86,-3.04),P=0.000;SMD=-3.81,95%CI(-5.79,-1.84),P=0.000;SMD=-1.99,95%CI(-2.83,-1.16),P=0.000;SMD=-4.22,95%CI(-7.43,-1.01),P=0.010),however,there was no statistical difference in the expression level of IL-1 in knee synovial fluid between the2 goups(SMD=-22.98,95%CI(-64.60,18.65),P=0.280).Publication bias was analyzed based on the Mankin scores,and the results of Bgger's test showed that there was no publication bias in the included artidles(P=0.074).Conclusion:Available evidences suggest that the acupotomy intervention can reduce knee pain and swelling,improve knee function and his-topathologie form o
作者
徐文博
汪利合
刘林枫
张文欣
XU Wenbo;WANG Lihe;LIU Linfeng;ZHANG Wenxin(College of Orthopaedics and Traumatology of Henan University of Chinese Medicine,Zhengzhou 450002,Henan China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)
出处
《中医正骨》
2023年第8期43-50,共8页
The Journal of Traditional Chinese Orthopedics and Traumatology
基金
河南省中医药拔尖人才培养项目(豫中医科教[2018]35号)。
关键词
骨关节炎
膝
针刀疗法
动物实验
兔
专题Meta分析
ostcoarhis,knee
acupotomy therapy
animal experimentation
abits
meta-analysis as topie
