[1]朱波 李勃△ 冯圣一 李刚.髓芯减压植骨术联合中药治疗股骨头坏死的Meta分析[J].中国中医骨伤科杂志,2019,27(11):39-47.
　ZHU Bo LI Bo FENG Shengyi LI Gang.Core Decompression and Bone Grafting Combined with Chinese Medicinal Herbs for Osteonecrosis of the Femoral Head:a Meta-analysis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(11):39-47.
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髓芯减压植骨术联合中药治疗股骨头坏死的Meta分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第27卷
期数:
2019年11期
页码:
39-47
栏目:
文献研究
出版日期:
2019-10-30

文章信息/Info

Title:
Core Decompression and Bone Grafting Combined with Chinese Medicinal Herbs for Osteonecrosis of the Femoral Head:a Meta-analysis
文章编号:
1005-0205(2019)11-0039-09
作者:
朱波1 李勃1△ 冯圣一1 李刚2
1上海中医药大学附属岳阳医院骨伤科(上海,200437 ) 2山东中医药大学附属医院骨科
Author(s):
ZHU Bo1 LI Bo1△ FENG Shengyi1 LI Gang2
1Orthopedics Department,Shanghai Yueyang Integrated Traditional Chinese Medicine and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China; 2Orthopedics Department,the Affi
关键词:
髓芯减压;  植骨;  中药;  股骨头坏死;  Meta分析
Keywords:
core decompression;  bone grafting;  Chinese medicinal herbs;  osteonecrosis of the femoral head;  meta-analysis
分类号:
R681.8
文献标志码:
A
摘要:
目的:通过Meta分析,评估在治疗早期ONFH时,髓芯减压植骨术联合CMH与不联合CMH的疗效差异。方法:在8个电子文献数据库中搜索相关的随机对照试验(RCT),检索时间截至2018年8月,研究包含髓芯减压植骨术联合CMH与不联合CMH对早期ONFH患者的影响。采用标准的Meta分析技术,用Review Manager 5.3软件对达到纳入标准的论文数据进行分析。结果:共纳入17项RCT,涉及1 159例ONFH患者,Meta分析结果显示:就总体疗效而言,OR值为1.23,95%CI为1.16～1.29,P<0.000 01; Harris评分,WMD为8.68,95%CI为6.36～11.01,P<0.000 01; VAS评分,WMD为-1.23,95%CI为-1.33～-1.13,P<0.000 01; 影像学改善,OR为2.52,95%CI为1.33～4.75,P=0.004; Z=2.95,P=0.003; Z=10.08,P<0.000 01,差异有统计学意义。此外,CMH的副作用发生率非常低。结论:治疗早期ONFH联合CMH疗效明显优于单纯髓芯减压植骨术。然而,已发表研究的质量并不令人满意,需要更大规模的随机对照试验证实,同时患者群体需要更加同质,随访时间也应更长。
Abstract:
Objective:A meta-analysis was performed to evaluate the effect of core decompression and bone grafting combined with CMH(Chinese medicinal herbs)on patients with early-stage ONFH(osteonecrosis of the femoral head)as compared with the hip-preserving operations alone.Methods:Eight electronic literature databases were searched for randomized controlled trials(RCTs)investigating the effects of core decompression and bone grafting combined with CMH versus without CMH on patients with early-stage ONFH,up to August,2018.Standard meta-analytic techniques were applied by employing Review Manager5.3 to analyze data from papers that reached acceptable criteria.Results:A total of 17 RCTs involving 1 159 patients with ONFH were included in this meta-analysis.The results of the meta-analysis showed that:in terms of overall efficacy(OR of 1.23,95% CI of 1.16～1.29,P<0.000 01),Harris score(WMD of 8.68,95% CI of 6.36～11.01,P<0.000 01),VAS score(WMD of -1.23,95% CI of -1.33～-1.13,P<0.000 01)and imaging improvement(OR of 2.52,95% CI of 1.33～4.75,P=0.004; Z=2.95,P=0.003; Z=10.08,P<0.000 01),the comparison was statistically significant.Besides,CMH has a very low incidence of side effects.Conclusion:These findings demonstrated that core decompression and bone grafting combined with CMH was apparently better than without CMH in the treatment of early-stage ONFH.However,the quality of published studies was unsatisfactory.It needs to be confirmed in a larger series of RCTs with a more homogeneous group of patients and a longer follow-up.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金面上项目(81774333) 上海市卫生和计划生育委员会“中医药事业发展三 年行动计划”(ZY(2018-2020)-ZWB-1001-CPJS49) 上海市卫生和计划生育委员会“中医特色诊疗技术 提升项目”(Zyjx-2017006) △通信作者 E-mail:libo@shyueyanghospital.com(收稿日期:2019-05-03)
更新日期/Last Update: 2019-10-30