Efficacy of Intra-articular Injection of Sodium Hyaluronate for Kashin-beck Disease: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 XULi , LIAOYu-lin , XIEDong-mei ,  YUEJi-rong

Department of Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding?author：

YUEJi-rong, Email: yuejirong11@hotmail.com

Keywords：

Kashin-beck disease; Sodium hyaluronate; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20160146

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Objectives To systematically review the efficacy of intra-articular injection of sodium hyaluronate for kashin-beck disease. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 1, 2016), CBM, VIP, WanFang Data, and CNKI were electronically searched from inception to January 2016 to collect randomized controlled trials (RCTs) about sodium hyaluronate in the treatment of kashin-beck disease. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software. Results A total of 6 RCTs involving 1 276 patients were included. The result of metaanalysis suggested that the sodium hyaluronate group was significantly superior to the control group in clinical effect (OR=5.89, 95% CI 4.10 to 8.47, P < 0.000 01) and the Lequesne index (SMD=-1.66, 95% CI-2.14 to-1.13, P < 0.000 01). Conclusion Intra-articular injection of sodium hyaluronate is helpful in the improvement of kashin-beck disease in clinical effect and the Lequesne index. Due to the limited quality and quantity of the included studies, more high quality studies are need to verify the above conclusion.

Citation： XULi, LIAOYu-lin, XIEDong-mei, YUEJi-rong. Efficacy of Intra-articular Injection of Sodium Hyaluronate for Kashin-beck Disease: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(8): 947-952. doi: 10.7507/1672-2531.20160146 Copy

1.	?王治倫, 周曉榮, 陳靜宏, 等.我們對大骨節病病因和發病機制的研究進展.中國地方病防治雜志, 2015, 30(5):341-344.
2.	王志武, 劉運起, 劉錦先.關于大骨節病控制標準研制的回顧.中國地方病防治雜志, 1995, 10(3):168-169.
3.	滕瑞濤, 劉永笑, 孫建純, 等.我國大骨節病流行概況.中國地方病學雜志, 1985, 4(4):3-8.
4.	郝振勇, 于洪文, 王清華, 等.大骨節病性膝關節炎的分階段性治療.航空航天醫學雜志, 2016, 27(3):384-385.
5.	余方方, 任峰玲, 孫麗, 等.透明質酸鈉和硫酸氨基葡萄糖治療成人大骨節病的成本-效果分析.中國地方病防治雜志, 2014, 29(5): 324-326.
6.	Guo X, Ma WJ, Zhang F, et al. Recent advances in the research of an endemic osteochondropathy in China:Kashin-Beck disease. Osteoarthritis Cartilage, 2014, 22(11):1774-1783.
7.	Jirong Y, Huiyun P, Zhongzhe Y, et al. Sodium selenite for treatment of Kashin-Beck disease in children:A systematic review of randomised controlled trials. Osteoarthritis Cartilage, 2012, 20(7): 605-613.
8.	余方方, 任峰玲, 方華, 等.膝關節腔注射透明質酸鈉對成人大骨節病患者生存質量的影響.中國地方病學雜志, 2015, 34(5):376-378.
9.	劉煥, 鄭潔, 劉佳鈺, 等.玻璃酸鈉聯合中藥秦息痛治療膝關節疼痛為主的大骨節病、類風濕關節炎的療效及安全性評價.中國地方病防治雜志, 2014, 29(4):258-259.
10.	朱春亮, 夏松鷹, 于金山.膝關節鏡下關節清理術加腔內注射透明質酸鈉治療大骨節病療效觀察.中國地方病學雜志, 2011, 30(4): 469-469.
11.	何昌謀, 郭雄.膝關節腔注射透明質酸鈉對成人大骨節病血清透明質酸、CD44、硫酸角質素含量的影響.中華臨床醫師雜志(電子版), 2011, 16(16):4852-4854.
12.	Tang X, Zhou ZK, Liu G, et al. The long-term efficacy and tolerability of hyaluronic acid in adult patients with Kashin-Beck disease of the knee. Clin Rheumatol, 2015, 34(1):151-156.
13.	Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). The Cochrane Collaboration, 2011. Available at:http://wwwcochrane-handbookorg.
14.	Tang X, Pei FX, Zhou ZK, et al. A randomized, single-blind comparison of the efficacy and tolerability of hyaluronate acid and meloxicam in adult patients with Kashin-Beck disease of the knee. Clin Rheumatol, 2012, 31(7):1079-1083.
15.	Wang W, Yuan P, Guo X. Intraarticular injection of hyaluronic acid in knee and physical therapy agents for the treatment of kashin beck disease:A prospective interventional study. Osteoarthritis Cartilage, 2015, 23(S2):A332-A333.
16.	許鵬, 郭雄, 靳衛章, 等.關節腔內注射透明質酸鈉治療大骨節病的療效觀察.中國地方病學雜志, 2004, 23(6):588-590.
17.	于曰祥, 郭大偉, 黃烈慶, 等.關節清理術后注射透明質酸鈉治療晚期大骨節病療效.中國地方病防治雜志, 2011, (3):185-187.
18.	余方方, 夏傳濤, 方華, 等.關節功能障礙指數評價透明質酸鈉治療大骨節病的遠期效果.中國地方病學雜志, 2014, 33(6):685-688.
19.	Xia CT, Yu FF, Ren FL, et al. Hyaluronic acid and glucosamine sulfate for adult Kashin-Beck disease:a cluster-randomized, placebocontrolled study. Clin Rheumatol, 2016, 35(5):1263-1270.
20.	Luo R, Liu G, Liu W, et al. Efficacy of celecoxib, meloxicam and paracetamol in elderly Kashin-Beck disease (KBD) patients. International Orthopaedics, 2011;35(9):1409-1414.
21.	Yue J, Yang M, Yi S, et al. Chondroitin sulfate and/or glucosamine hydrochloride for Kashin-Beck disease:a cluster-randomized, placebo-controlled study. Osteoarthritis and Cartilage, 2012, 20(7): 622-629.
22.	Kul-Panza E, Berker N. Is hyaluronate sodium effective in the management of knee osteoarthritis? A placebo-controlled doubleblind study. Minerva Medica, 2010, 101(2):63-72.
23.	Bannuru RR, Natov NS, Obadan IE, et al. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis:a systematic review and meta-analysis. Arthritis Rheum, 2009, 61(12):1704-1711.
24.	Petrella RJ, DiSilvestro MD, Hildebrand C. Effects of hyaluronate sodium on pain and physical functioning in osteoarthritis of the knee:a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med, 2002, 162(3):292-298.
25.	蔣勰, 占美, 李棋, 等.關節鏡下清理術聯合關節內透明質酸注射治療膝關節骨關節炎有效性的系統評價.中國循證醫學雜志, 2012, 12(11):1361-1366.
26.	Yu FF, Xia CT, Fang H, et al. Evaluation of the therapeutic effect of treatment with intra-articular hyaluronic acid in knees for KashinBeck disease:A meta-analysis. Osteoarthritis Cartilage, 2014, 22(6): 718-725.
27.	劉麗軍, 張曉慧, 魏大河, 等.生物填充療法治療西藏大骨節病患者血清細胞因子水平和療效觀察.西藏大學學報:自然科學版, 2011, 26(2):56-59.

1. ?王治倫, 周曉榮, 陳靜宏, 等.我們對大骨節病病因和發病機制的研究進展.中國地方病防治雜志, 2015, 30(5):341-344.
2. 王志武, 劉運起, 劉錦先.關于大骨節病控制標準研制的回顧.中國地方病防治雜志, 1995, 10(3):168-169.
3. 滕瑞濤, 劉永笑, 孫建純, 等.我國大骨節病流行概況.中國地方病學雜志, 1985, 4(4):3-8.
4. 郝振勇, 于洪文, 王清華, 等.大骨節病性膝關節炎的分階段性治療.航空航天醫學雜志, 2016, 27(3):384-385.
5. 余方方, 任峰玲, 孫麗, 等.透明質酸鈉和硫酸氨基葡萄糖治療成人大骨節病的成本-效果分析.中國地方病防治雜志, 2014, 29(5): 324-326.
6. Guo X, Ma WJ, Zhang F, et al. Recent advances in the research of an endemic osteochondropathy in China:Kashin-Beck disease. Osteoarthritis Cartilage, 2014, 22(11):1774-1783.
7. Jirong Y, Huiyun P, Zhongzhe Y, et al. Sodium selenite for treatment of Kashin-Beck disease in children:A systematic review of randomised controlled trials. Osteoarthritis Cartilage, 2012, 20(7): 605-613.
8. 余方方, 任峰玲, 方華, 等.膝關節腔注射透明質酸鈉對成人大骨節病患者生存質量的影響.中國地方病學雜志, 2015, 34(5):376-378.
9. 劉煥, 鄭潔, 劉佳鈺, 等.玻璃酸鈉聯合中藥秦息痛治療膝關節疼痛為主的大骨節病、類風濕關節炎的療效及安全性評價.中國地方病防治雜志, 2014, 29(4):258-259.
10. 朱春亮, 夏松鷹, 于金山.膝關節鏡下關節清理術加腔內注射透明質酸鈉治療大骨節病療效觀察.中國地方病學雜志, 2011, 30(4): 469-469.
11. 何昌謀, 郭雄.膝關節腔注射透明質酸鈉對成人大骨節病血清透明質酸、CD44、硫酸角質素含量的影響.中華臨床醫師雜志(電子版), 2011, 16(16):4852-4854.
12. Tang X, Zhou ZK, Liu G, et al. The long-term efficacy and tolerability of hyaluronic acid in adult patients with Kashin-Beck disease of the knee. Clin Rheumatol, 2015, 34(1):151-156.
13. Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). The Cochrane Collaboration, 2011. Available at:http://wwwcochrane-handbookorg.
14. Tang X, Pei FX, Zhou ZK, et al. A randomized, single-blind comparison of the efficacy and tolerability of hyaluronate acid and meloxicam in adult patients with Kashin-Beck disease of the knee. Clin Rheumatol, 2012, 31(7):1079-1083.
15. Wang W, Yuan P, Guo X. Intraarticular injection of hyaluronic acid in knee and physical therapy agents for the treatment of kashin beck disease:A prospective interventional study. Osteoarthritis Cartilage, 2015, 23(S2):A332-A333.
16. 許鵬, 郭雄, 靳衛章, 等.關節腔內注射透明質酸鈉治療大骨節病的療效觀察.中國地方病學雜志, 2004, 23(6):588-590.
17. 于曰祥, 郭大偉, 黃烈慶, 等.關節清理術后注射透明質酸鈉治療晚期大骨節病療效.中國地方病防治雜志, 2011, (3):185-187.
18. 余方方, 夏傳濤, 方華, 等.關節功能障礙指數評價透明質酸鈉治療大骨節病的遠期效果.中國地方病學雜志, 2014, 33(6):685-688.
19. Xia CT, Yu FF, Ren FL, et al. Hyaluronic acid and glucosamine sulfate for adult Kashin-Beck disease:a cluster-randomized, placebocontrolled study. Clin Rheumatol, 2016, 35(5):1263-1270.
20. Luo R, Liu G, Liu W, et al. Efficacy of celecoxib, meloxicam and paracetamol in elderly Kashin-Beck disease (KBD) patients. International Orthopaedics, 2011;35(9):1409-1414.
21. Yue J, Yang M, Yi S, et al. Chondroitin sulfate and/or glucosamine hydrochloride for Kashin-Beck disease:a cluster-randomized, placebo-controlled study. Osteoarthritis and Cartilage, 2012, 20(7): 622-629.
22. Kul-Panza E, Berker N. Is hyaluronate sodium effective in the management of knee osteoarthritis? A placebo-controlled doubleblind study. Minerva Medica, 2010, 101(2):63-72.
23. Bannuru RR, Natov NS, Obadan IE, et al. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis:a systematic review and meta-analysis. Arthritis Rheum, 2009, 61(12):1704-1711.
24. Petrella RJ, DiSilvestro MD, Hildebrand C. Effects of hyaluronate sodium on pain and physical functioning in osteoarthritis of the knee:a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med, 2002, 162(3):292-298.
25. 蔣勰, 占美, 李棋, 等.關節鏡下清理術聯合關節內透明質酸注射治療膝關節骨關節炎有效性的系統評價.中國循證醫學雜志, 2012, 12(11):1361-1366.
26. Yu FF, Xia CT, Fang H, et al. Evaluation of the therapeutic effect of treatment with intra-articular hyaluronic acid in knees for KashinBeck disease:A meta-analysis. Osteoarthritis Cartilage, 2014, 22(6): 718-725.
27. 劉麗軍, 張曉慧, 魏大河, 等.生物填充療法治療西藏大骨節病患者血清細胞因子水平和療效觀察.西藏大學學報:自然科學版, 2011, 26(2):56-59.

Chinese Journal of Evidence-Based Medicine

Efficacy of Intra-articular Injection of Sodium Hyaluronate for Kashin-beck Disease: A Meta-analysis

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