Systematic Evaluation Of Clinical Efficacy Of KOA Based On GRADE System In The Treatment Of KOA

Objective:Systematically evaluate the effect of knee osteoarthritis of traditional Chinese medicine steam bath combined with conventional therapy.Methods:Two system valuators to extract keywords,to develop Scientific and effective literature retrieval strategy,Using the computer retrieval of China hownet(CNKI),The Chinese biomedical literature database(CBM),VIP database(VIP),Ten thousand digital periodical group(WF),Pubmed database in lately five years of literature.All included the literature which regard Chinese traditional medicine herbal steam bath or the treatments of Chinese traditional medicine herbal steam bath of KOA as main content to be treatment group,the literature which regard regular treatment of KOA as main content to be control group,Formulate inclusion criteria and exclusion criteria,include 18 papers in accordance with inclusion criteria.According to the Cochrane Handbook5.1 recommended bias risk assessment tools,valuate the included literature's quality,using Revman5.3 software to analyze the collected data,Subgroup analysis is based on the combination of different routine therapy,divided into four subgroup,respectively : "Chinese medicine steam bath" subgroup," Chinese medicine steam bath combined with ecletric needling" subgroup,"Chinese medicine steam bath with oral medicine Meloxicam + glucosamine" subgroups," Chinese medicine steam bath with articular cavity injection of sodium hyaluronate" subgroups,Using clinical effective rate as outcome assessment.Create a funnel chart to analyse potential publication bias.Use GRADE(Evidence quality grading system)to classify the outcome of evidence quality.Results :Finally include 18 literatures,study includes 1761 participants,913 patients in treatment group,848 in control group.Through Meta analysis shows 95% of CI is [[2.53,4.78]],its whole effect test is Z=7.67,P<0.00001.Funnel graphics is symmetry which means bias risk is low.Subgroups analysis outcome show: Chinese medicine steam bath subgroup:OR=2.44,95% of CI is [1.01,5.93],test for overall effect Z=1.98,P<0.00001;Chinese medicine steam bath combined with electric needling subgroup: OR=2.39,95%of CI is[1.36,4.20],test for overall effect Z=3.04,P<0.00001;Chinese medicine steam bath with oral medicine Meloxicam + glucosamine subgroup:OR=1.65,95%of CI is [0.68,4.02],,test for overall effect Z=1.10,P=0.27,Chinese medicine steam bath with articular cavity injection of sodium hyaluronate" subgroup:OR=6.20,95% of CI is [3.69,10.41],,test for overall effect Z=6.90,P<0.00001?GRADE shows : Evidence level of traditional Chinese medicine steam bath combined with conventional therapy and conventional therapy is low,Evidence level of Chinese medicine steam bath subgroup is extremely low,Evidence level of Chinese medicine steam bath combined with electric needling subgroup is low,Evidence level of Chinese medicine steam bath with oral medicine Meloxicam + glucosamine subgroup is extremely low,Evidence level of Chinese medicine steam bath with articular cavity injection of Sodium hyaluronate group is low.