Résumé
Objective:To revaluate the systematic review/meta-analysis on efficacy and safety of acupuncture treatment for knee osteoarthritis.Methods:We searched CNKI, VIP, WangFang, CBM, PubMed, Cochrane Library databases, Embase, from inception to December 15, 2020, to retrieve systematic reviews and/or meta analyses on the treatment of knee osteoarthritis with acupuncture and moxibustion. Two researchers independently screened the literature and extracted data, used the AMSTAR2 scale to evaluate the methodological quality, and used the GRADE system to grade the quality of evidence.Results:A total of 11 systematic evaluations were included, including 44 outcomes. Methodological evaluation showed that all 11 literatures were of very low quality. The GRADE system evaluation showed that there were 13 intermediate evidences, 12 low evidences, and 19 very low evidences.Conclusion:The results of the existing systematic reviews show that acupuncture and moxibustion have a certain efficacy in the treatment of knee osteoarthritis, but the methodology and evidence level of the included studies are low, so this conclusion needs to be verified by further high-quality studies.
Résumé
OBJECTIVE: Chronic osteomyelitis is a difficult orthopedic disease. The treatment process is complicated and prolonged. It is easy to relapse. At present, studies have confirmed that antibiotic artificial bone is effective in treating chronic osteomyelitis, but there is still no evidence-based basis. This study systematically evaluated the clinical efficacy and safety of antibiotic artificial bone in the treatment of chronic osteomyelitis. METHODS: The authors searched relevant literature in CNKI, Wanfang, VIP, CBM, PubMed, and Cochrane Llibrary databases. The limit of searching time was from inception to April 2020. Randomized controlled trials on the use of antibiotic artificial bones for chronic osteomyelitis were collected according to the criteria for inclusion and exclusion. Two researchers independently screened, evaluated, and extracted the retrieved documents. The quality evaluation was carried out according to the Cochrane evaluation manual and the NOS scale. The literature data were analyzed using RevMan 5.3 software through a meta-analysis. RESULTS: (1) Two randomized controlled clinical trials evaluated moderately biased quality, and 11 retrospective studies evaluated high-quality literature. A total of 744 patients were included in 13 clinical control trials, including 387 patients in the treatment group and 357 patients in the control group. (2) The results of meta-analysis showed that the treatment group had significant differences from the control group in terms of infection clearance rate, fracture healing rate, fracture healing time, incision healing time, treatment efficiency, length of stay, reoperation rate, complication rate and recurrence rate, and the treatment group was superior to the control group (P < 0.05). CONCLUSION: Antibiotic artificial bone treatment of chronic osteomyelitis can improve the treatment efficiency, shorten the treatment time, better control infection, and reduce complications and recurrence rate. This conclusion also needs a larger sample and higher quality randomized controlled trials to verify.