雷露　朱明海

【摘 要】目的：系统评价独活寄生汤治疗膝骨关节炎的临床疗效。方法：检索2006年1月至2014年

12月维普网、万方数据库、中国知网中采用独活寄生汤治疗膝骨关节炎的相关文献，并进行汇总，采用Reviews Manager 5.2软件进行Meta分析。结果：共检索出50篇相关文献，符合纳入标准的有14篇，

14篇文献均未提及是否采用盲法，且均采用随机对照研究，共1815例患者，其中治疗组971例，对照组844例。Meta分析结果显示，独活寄生汤治疗膝骨关节炎有效率的比值比为5.01；95%可信区间[3.74，6.72]，治疗组总有效率优于对照组，差异有统计学意义（P < 0.000 01）。结论：独活寄生汤治疗膝骨关节炎较对照组有效，可改善患者的临床症状，减轻患者的痛苦和疼痛，临床治愈率仍有待提高。

【关键词】 骨关节炎，膝；独活寄生汤；随机对照试验；Meta分析

doi：10.3969/j.issn.2095-4174.2016.01.007

Meta-analysis of Clinical Literature with Randomized Controlled Trials on the Treatment of Knee Osteoarthritis with Duhuo Jisheng Tang （独活寄生汤）

LEI Lu，ZHU Ming-hai

【ABSTRACT】Objective：To systematically assess the clinical efficacy of Duhuo Jisheng Tang（独活寄

生汤）in the treatment of knee osteoarthritis.Methods：Made a retrieval of literatures （2006.01～2014.12） on the treatment of knee osteoarthritis with Duhuo Jisheng Tang from VIP network，Wanfang Data，China National Knowledge Infrastructure（CNKI）.The reviews manager 5.2 software was used for meta-analysis.Results：14 articles

meeting the inclusion criteria were chosen from the 50 ones retrieved，among which there were 1815 patients，

971 of which were in the treatment group and 844 in the control group.Meta-analysis results showed that the ratio of efficacy for the treatment of knee osteoarthritis with Duhuo Jisheng Tang was 5.01，with 95% confidence interval[3.74，6.72].The total effective rate of the treatment group was better than that of the control group，the difference being statistically significant （P < 0.000 01）.Conclusion：Compared with the control group，treating knee osteoarthritis with Duhuo Jisheng Tang can improve patients clinical symptoms and relieve patient's pain，but the clinical cure rate still needs to be improved.

【Keywords】osteoarthritis，knee；Duhuo Jisheng Tang（独活寄生汤）；randomized controlled trials；Meta-analysis

骨关节炎（osteoarthritis，OA）是一种慢性骨关节疾病，主要以关节软骨退行性变及继发性骨质增生为特征。中医学称为“痹证”。常见于中老年人，且以女性多见。膝关节、髋关节、脊柱及远端指间关节等部位因负重较大而较多发，故又称骨关节病、退行性OA、增生性OA等。疼痛为其重要症状，且以轻微钝痛为始发，后症状日渐加重，动则痛剧，休息后减轻。平静状态下或晨起时即感到疼痛，轻微活动后可缓解，称之为“休息痛”。但运动一旦超过自身负荷，关节面会因摩擦而产生疼痛。疼痛症状也可能受天气突然变化、潮湿、寒冷等因素的影响。中期患者常感到关节活动不利，甚则上下楼困难，晨起或长时间处于某一特殊体位时关节出现僵硬，活动后即可减轻。关节运动时发出不同的弹响，甚至有时可能会出现关节交锁症状。……