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

Video：

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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.	王治伦, 周晓荣, 陈静宏, 等.我们对大骨节病病因和发病机制的研究进展.中国地方病防治杂志, 2015, 30(5):341-344.
2.	王志武, 刘运起, 刘锦先.关于大骨节病控制标准研制的回顾.中国地方病防治杂志, 1995, 10(3):168-169.
3.	滕瑞涛, 刘永笑, 孙建纯, 等.我国大骨节病流行概况.中国地方病学杂志, 1985, 4(4):3-8.
4.	郝振勇, 于洪文, 王清华, 等.大骨节病性膝关节炎的分阶段性治疗.航空航天医学杂志, 2016, 27(3):384-385.
5.	余方方, 任峰玲, 孙丽, 等.透明质酸钠和硫酸氨基葡萄糖治疗成人大骨节病的成本-效果分析.中国地方病防治杂志, 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, 方华, 等.膝关节腔注射透明质酸钠对成人大骨节病患者生存质量的影响.中国地方病学杂志, 2015, 34(5):376-378.
9.	刘焕, 郑洁, 刘佳钰, 等.玻璃酸钠联合中药秦息痛治疗膝关节疼痛为主的大骨节病、类风湿关节炎的疗效及安全性评价.中国地方病防治杂志, 2014, 29(4):258-259.
10.	朱春亮, 夏松鹰, 于金山.膝关节镜下关节清理术加腔内注射透明质酸钠治疗大骨节病疗效观察.中国地方病学杂志, 2011, 30(4): 469-469.
11.	何昌谋, 郭雄.膝关节腔注射透明质酸钠对成人大骨节病血清透明质酸、CD44、硫酸角质素含量的影响.中华临床医师杂志(电子版), 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.	许鹏, 郭雄, 靳卫章, 等.关节腔内注射透明质酸钠治疗大骨节病的疗效观察.中国地方病学杂志, 2004, 23(6):588-590.
17.	于曰祥, 郭大伟, 黄烈庆, 等.关节清理术后注射透明质酸钠治疗晚期大骨节病疗效.中国地方病防治杂志, 2011, (3):185-187.
18.	余方方, 夏传涛, 方华, 等.关节功能障碍指数评价透明质酸钠治疗大骨节病的远期效果.中国地方病学杂志, 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.	蒋勰, 占美, 李棋, 等.关节镜下清理术联合关节内透明质酸注射治疗膝关节骨关节炎有效性的系统评价.中国循证医学杂志, 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.	刘丽军, 张晓慧, 魏大河, 等.生物填充疗法治疗西藏大骨节病患者血清细胞因子水平和疗效观察.西藏大学学报:自然科学版, 2011, 26(2):56-59.

1. 王治伦, 周晓荣, 陈静宏, 等.我们对大骨节病病因和发病机制的研究进展.中国地方病防治杂志, 2015, 30(5):341-344.
2. 王志武, 刘运起, 刘锦先.关于大骨节病控制标准研制的回顾.中国地方病防治杂志, 1995, 10(3):168-169.
3. 滕瑞涛, 刘永笑, 孙建纯, 等.我国大骨节病流行概况.中国地方病学杂志, 1985, 4(4):3-8.
4. 郝振勇, 于洪文, 王清华, 等.大骨节病性膝关节炎的分阶段性治疗.航空航天医学杂志, 2016, 27(3):384-385.
5. 余方方, 任峰玲, 孙丽, 等.透明质酸钠和硫酸氨基葡萄糖治疗成人大骨节病的成本-效果分析.中国地方病防治杂志, 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, 方华, 等.膝关节腔注射透明质酸钠对成人大骨节病患者生存质量的影响.中国地方病学杂志, 2015, 34(5):376-378.
9. 刘焕, 郑洁, 刘佳钰, 等.玻璃酸钠联合中药秦息痛治疗膝关节疼痛为主的大骨节病、类风湿关节炎的疗效及安全性评价.中国地方病防治杂志, 2014, 29(4):258-259.
10. 朱春亮, 夏松鹰, 于金山.膝关节镜下关节清理术加腔内注射透明质酸钠治疗大骨节病疗效观察.中国地方病学杂志, 2011, 30(4): 469-469.
11. 何昌谋, 郭雄.膝关节腔注射透明质酸钠对成人大骨节病血清透明质酸、CD44、硫酸角质素含量的影响.中华临床医师杂志(电子版), 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. 许鹏, 郭雄, 靳卫章, 等.关节腔内注射透明质酸钠治疗大骨节病的疗效观察.中国地方病学杂志, 2004, 23(6):588-590.
17. 于曰祥, 郭大伟, 黄烈庆, 等.关节清理术后注射透明质酸钠治疗晚期大骨节病疗效.中国地方病防治杂志, 2011, (3):185-187.
18. 余方方, 夏传涛, 方华, 等.关节功能障碍指数评价透明质酸钠治疗大骨节病的远期效果.中国地方病学杂志, 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. 蒋勰, 占美, 李棋, 等.关节镜下清理术联合关节内透明质酸注射治疗膝关节骨关节炎有效性的系统评价.中国循证医学杂志, 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. 刘丽军, 张晓慧, 魏大河, 等.生物填充疗法治疗西藏大骨节病患者血清细胞因子水平和疗效观察.西藏大学学报:自然科学版, 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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