氨基葡萄糖治疗治疗骨关节炎。
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红眼雀TE,麦克斯韦L Anastassiades TP,谢伊B, Houpt J,罗宾逊V,业务MC,井G
氨基葡萄糖治疗治疗骨关节炎。
科克伦数据库系统启2005年4月18日;(2):CD002946。
- PubMed ID
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15846645 (在PubMed]
- 文摘
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背景:骨关节炎(OA)是最常见的关节炎,并常与重大残疾和生活质量的受损。目的:回顾所有的随机对照试验(相关的)评估的有效性和毒性在OA氨基葡萄糖。搜索策略:我们检索MEDLINE、PREMEDLINE EMBASE,艾湄湾,ACP杂志俱乐部,敢,CDSR, CCTR。我们还写信给内容专家和手参考确认相关的列表和搜索相关的评论文章。搜索都是更新2005年1月。选择标准:相关研究符合以下标准:1)相关的评估的有效性和安全性在OA葡萄糖胺,2)安慰剂对照和比较研究都合格,3)单盲法和双盲研究都是合格的。数据收集和分析:由两个独立调查员和执行数据抽象程度的协议的结果进行了比较。Gotzsche的方法和验证工具(Jadad 1996)被用来分数相关的质量。连续结果措施集中使用标准化意味着差异(SMD)的测量效果。二分结果措施是使用相对危险度比率(RR)。 MAIN RESULTS: Analysis restricted to eight studies with adequate allocation concealment failed to show benefit of glucosamine for pain and WOMAC function. Collectively, the 20 analyzed RCTs found glucosamine favoured placebo with a 28% (change from baseline) improvement in pain (SMD -0.61, 95% CI -0.95, -0.28) and a 21% (change from baseline) improvement in function using the Lequesne index (SMD -0.51 95% CI -0.96, -0.05). However, the results are not uniformly positive, and the reasons for this remain unexplained. WOMAC pain, function and stiffness outcomes did not reach statistical significance. In the 10 RCTs in which the Rotta preparation of glucosamine was compared to placebo, glucosamine was found to be superior for pain (SMD -1.31, 95% CI -1.99, -0.64) and function using the Lequesne index (SMD -0.51, 95% CI -0.96, -0.05). Pooled results for pain (SMD -0.15, 95% CI -0.35, 0.05) and function using the WOMAC index (SMD 0.03, 95% CI -0.18, 0.25) in those RCTs in which a non-Rotta preparation of glucosamine was compared to placebo did not reach statistical significance. In the four RCTs in which the Rotta preparation of glucosamine was compared to an NSAID, glucosamine was superior in two, and equivalent in two. Two RCTs using the Rotta preparation showed that glucosamine was able to slow radiological progression of OA of the knee over a three year period (SMD 0.24, 95% CI 0.04, 0.43). Glucosamine was as safe as placebo in terms of the number of subjects reporting adverse reactions (RR=0.97, 95% CI, 0.88, 1.08). AUTHORS' CONCLUSIONS: This update includes 20 studies with 2570 patients. Pooled results from studies using a non-Rotta preparation or adequate allocation concealment failed to show benefit in pain and WOMAC function while those studies evaluating the Rotta preparation show that glucosamine was superior to placebo in the treatment of pain and functional impairment resulting from symptomatic OA. WOMAC outcomes of pain, stiffness and function did not show a superiority of glucosamine over placebo for both Rotta and non-Rotta preparations of glucosamine. Glucosamine was as safe as placebo.
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