灸法治疗膝骨关节炎的网状Meta分析
Network Meta Analysis of Moxibustion in the Treatment of Knee Osteoarthritis
摘要: 目的：基于网状Meta分析不同灸法对膝骨关节炎患者的疗效，并进行排序，以期为临床选择灸法治疗膝骨关节炎的最佳灸法方案提供参考。方法：计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献(CBM)四个中文数据库及PubMed、The Cochrane Library、Web of science、Embase 8个数据库，从建库至2023年6月30日灸法治疗膝骨关节炎的随机对照试验，按照纳排标准进行文献筛选，根据Cochrane偏倚风险评估工具进行质量评价，采用Stata MP 17.0软件进行基于频率学框架的网状Meta分析。结果：纳入符合标准33篇文献，涉及11种不同的施灸方案，对照组为常规护理治疗或假灸法。网状meta分析结果显示，麦粒灸在缓解膝骨关节炎患者疼痛方面效果最佳；WOMAC方面，器具灸效果最佳；在有效率方面，特殊灸法 + 常规治疗效果较好。结论：灸法对治疗膝骨关节炎有一定的疗效，但对于疾病的不同方面，灸法疗效不同。临床上应结合患者不同的疾病情况给出相应的治疗措施，此外，文献纳入文献偏倚风险较高，需要更多大规模、高质量的RCT进一步验证。
Abstract: Objective: To analyze the curative effects of different moxibustion methods on patients with knee osteoarthritis based on reticular meta-analysis, and rank them, so as to provide reference for clinical selection of the best moxibustion scheme for treating knee arthritis. Methods: Four Chinese databases (CNKI, Wanfang, VIP and China Biomedical Literature (CBM)) and eight databases (PubMed, The Cochrane Library, Web of science, Embase) were searched by computer. From the establishment of the database to June 30, 2023, the randomized controlled trial of moxibustion for knee osteoarthritis was conducted. Literature screening was conducted according to the standard of admission, quality evaluation was carried out according to Cochrane bias risk assessment tool, and network meta-analysis based on frequency framework was carried out by Stata MP 17.0 software. Results: Thirty-three literatures were included, involving 11 different moxibustion schemes, and the control group was treated with routine nursing or sham moxibustion. According to the value of SUCRA under the cumulative ranking probability diagram, in terms of VAS score, wheat grain moxibustion has the best effect; in WOMAC, appliance moxibustion has the best effect; in terms of effective rate, special moxibustion plus routine treatment has better effect. Conclusion: Moxibustion has a certain curative effect on knee osteoarthritis, but it has different curative effects for different diseases. Clinically, corresponding treatment measures should be given according to patients’ different diseases. In addition, the risk of literature bias is high, and more large-scale and high-quality RCT is needed for further verification.
文章引用：吴蒙, 薛辉, 牟艳丽, 陈丽金, 罗丽, 张超. 灸法治疗膝骨关节炎的网状Meta分析[J]. 中医学, 2025, 14(8): 3689-3703. https://doi.org/10.12677/tcm.2025.148537

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