Efficacy of traditional Chinese medicine therapy and hyaluronic acid for knee osteoarthritis：a networkMeta-analysis / 中国组织工程研究

ABSTRACT

BACKGROUND:Comparative study results between the efficacies of traditional Chinese medicine (TCM) therapy with Western medicine therapy in the treatment of knee osteoarthritis remain controversial. Currently, meta-analysis studies mainly focuson comparison of the efficacy between TCM and Western medicine,butlack investigations among TCM therapies. Itmakes usdifficult tofulyunderstand the efficacy of TCM therapy for knee osteoarthritis. OBJECTIVE:To compare the efficacies of TCM therapy with intra-articular injection of hyaluronic acid for knee osteoarthritis using a networkMeta-analysis method. METHODS:PubMed, The Cochrane Library (tissue 10, 2015), EMbase, CNKI, CBM, VIP, Wangfang databaseswere searchedup to October 20, 2015forrelevantrandomized controled trialsaddressingthe efficacies of TCM therapyversusintra-articular injection of hyaluronic acid for knee osteoarthritis. Two reviewers independently selected the studies, extracted information, and assessed the quality of included trials. Data extraction from eligible studies was pooled and meta-analyzed using Stata12.0 and WinBUGS1.4.3softwares. Odd ratios with their 95% confidence interval were estimated as effect size between treatments. RESULTS AND CONCLUSION:A total of 59 randomized controled trials involving 6 155 patients with knee osteoarthritis and 12 treatment strategies were included. The results of network meta-analysis showed that TCM comprehensive therapy wassuperior to the TCM monotherapy and intra-articular injection of hyaluronic acid. Among thesetherapies, the efficacy of needle scalpel combined with acupuncture is optimal. TCM comprehensive therapies may be the best choice to treat patients with knee osteoarthritisofKelgren-LawrenceII-III. Morelarge-scaleand wel-designedrandomized controled trials are stil warranted due to the limitation of the present study.