3种关节内注射药物治疗膝骨关节炎长期疗效的网状Meta分析 点击下载
| 论文标题： | 3种关节内注射药物治疗膝骨关节炎长期疗效的网状Meta分析 |
| 英文标题： | |
| 中文摘要： | 目的 评价关节内注射透明质酸（HA）、富血小板血浆（PRP）、自体微碎脂肪组织（MFAT）治疗膝骨关节炎（KOA）的长期疗效。方法检索PubMed、WebofScience、Embase、CochraneLibrary、中国知网、万方数据、维普网和中国生物医学文献服务系统以及各临床试验注册平台，收集KOA患者关节内注射上述3种药物的随机对照试验（RCT），检索时限为2016年1月至2025年12月。筛选文献、提取数据和评价纳入文献质量后，采用RevMan5.3、StataMP16.0软件进行网状Meta分析。结果共纳入31篇RCT，共计2964例患者。在缓解疼痛方面，PRP+HA、PRP治疗后6个月时患者的视觉模拟评分法（VAS）评分均显著低于生理盐水和HA治疗者（P＜0.05），累积排序曲线下面积（SUCRA）排名前2位的是PRP+HA、PRP；PRP治疗后12个月时患者的VAS评分显著低于HA和生理盐水治疗者（P＜0.05），SUCRA排名前2位的是PRP、PRP+HA。在功能改善方面，PRP治疗后6个月，MFAT、PRP、PRP+HA治疗后12个月时患者的西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分均显著低于HA或生理盐水治疗者（P＜0.05）；MFAT、PRP治疗后6、12个月时患者的国际膝关节文献委员会（IKDC）评分显著高于生理盐水治疗者（P＜0.05），PRP治疗后12个月时患者的IKDC评分显著高于HA治疗者（P＜0.05）；WOMAC评分、IKDC评分SUCRA排名前2位的均为MFAT、PRP。结论缓解疼痛方面，PRP+HA治疗后6个月时优势显著，单用PRP在治疗后12个月时具有潜在优势；功能改善方面，MFAT在治疗后6个月和12个月时显示出显著优势。 |
| 英文摘要： | OBJECTIVE To evaluate the long-term efficacy of intra-articular injection of hyaluronic acid （HA）， platelet-rich plasma （PRP）， and micro-fragmented adipose tissue （MFAT） in treatment of knee osteoarthritis （KOA）. METHODS Randomized controlled trials （RCTs） of KOA patients receiving intra-articular injection of the three agents were collected from PubMed， Web of Science， Embase， Cochrane Library， CNKI， Wanfang Data， VIP， Chinese Biomedical Literature Service System，and clinical trial registration platforms. The retrieval time limit was from January 2016 to December 2025. After screening the literature， extracting the data，and evaluating the quality of the literature， network meta-analysis was performed using RevMan 5.3 and Stata MP 16.0 software. RESULTS A total of 31 RCTs involving 2 964 patients were included. For pain relief， after 6 months of treatment， the Visual Analogue Scale （VAS） scores in the PRP+HA and PRP groups were significantly lower than those in the saline and HA groups （ P ＜0.05）， PRP+HA and PRP were ranked as the top two by surface under the cumulative ranking curve （SUCRA）. After 12 months of treatment， the VAS scores in the PRP group were significantly lower than those in the HA and saline groups （ P ＜0.05）， PRP and PRP+HA were ranked as the top two by SUCRA. For functional recovery， after 6 months of treatment， the Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） scores in the PRP group were significantly lower than those in the HA or saline groups （ P ＜0.05）. After 12 months of treatment， the WOMAC scores in the MFAT， PRP and PRP+HA groups were significantly lower than those in the HA or saline groups （ P ＜0.05）. After 6 and 12 months of treatment， International Knee Documentation Committee （IKDC） scores in the MFAT and PRP groups were significantly higher than the saline group （ P ＜0.05）， and after 12 months of treatment， the PRP group was significantly higher than the HA group （ P ＜0.05）. MFAT and PRP were ranked as the top two by SUCRA for both the WOMAC and IKDC scores. CONCLUSIONS For pain relief， PRP+HA showed a significant advantage at 6 months after treatment， whereas PRP alone demonstrated a notable superiority at 12 months after treatment. For functional recovery， MFAT exhibited a marked advantage at both 6 and 12 months after treatment. |
| 期刊： | 2026年第37卷第14期 |
| 作者： | 黄玉文；洪智涛；黄永原；苏虹；陈凯宁；韩杰；陈跃平；吴晓飞 |
| 英文作者： | HUANG Yuwen， HONG Zhitao，HUANG Yongyuan，SU Hong，CHEN Kaining，HAN Jie，CHEN Yueping，WU Xiaofei |
| 关键字： | 膝骨关节炎; 关节内注射; 透明质酸; 富血小板血浆; 自体微碎脂肪组织; 镇痛; 功能改善 |
| KEYWORDS： | knee osteoarthritis; intra-articular injection; hyaluronic acid; platelet-rich plasma; micro-fragmented adipose tissue; analgesia; functional recovery |
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