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      Efficacy of Duohuojisheng decoction monotherapy for the treatment of knee osteoarthritis : A protocol of a systematic review of randomized controlled trials

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          Abstract

          Background:

          This systematic review investigates the efficacy and safety of Duohuojisheng decoction (DHJSD) monotherapy for the treatment of patients with knee osteoarthritis (KOA).

          Methods:

          We searched relevant studies on DHJSD monotherapy for KOA from the databases of CENTRAL, EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Information, and Wanfang Data from the inception to January 1, 2019. Two researchers independently selected studies, collected data, and assessed the methodology quality by using Cochrane risk of bias tool.

          Results:

          This study evaluates the efficacy and safety of DHJSD monotherapy for KOA by assessing the pain intensity, stiffness, and disability of affected knee joints, and quality of life, as well as the adverse events.

          Conclusion:

          The results of this study provide latest updated evidence of DHJSD monotherapy alone for KOA.

          Ethics and dissemination:

          No ethical approval is required for this systematic review, because it is based on the published data, and not on individual patient data. Its findings is published in a peer-reviewed journal.

          PROSPERO registration number:

          PROSPERO CRD42019120405.

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          Most cited references17

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          Knee osteoarthritis: a review of management options

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            Traditional Chinese Medications for Knee Osteoarthritis Pain: A Meta-Analysis of Randomized Controlled Trials

            Traditional Chinese medication (TCM) has analgesic and anti-inflammatory effects in patients with knee osteoarthritis (OA). We conducted the first systematic review of the best quantitative and qualitative evidence currently available in order to evaluate the effectiveness of TCM in relieving pain in knee OA. A comprehensive literature search was conducted using three English and four Chinese biomedical databases from their inception through March 1, 2015. We included randomized controlled trials of TCM for knee OA with intervention durations of at least two weeks. The effects of TCM on pain and other clinical symptoms were measured with the visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The total effectiveness rate, which was used to assess overall pain, physical performance and wellness, was also measured. Two researchers independently extracted data on study design, population characteristics, duration, intervention, outcomes, risk of bias, and primary results. We performed a random-effects meta-analysis when appropriate. We also explored factors that could explain the heterogeneity by conducting subgroup and meta-regression analyses. Twenty-three studies, totaling 2362 subjects, met the eligibility criteria. Treatments were formulated with an average of 8 Chinese herbs and were prescribed based on the traditional Chinese diagnostic method of syndrome differentiation. The mean treatment duration was seven weeks, with oral administration occurring one to three times a day. Compared with non-steroidal anti-inflammatory drugs and intra-articular hyaluronate injections, 18 of the studies showed significantly improved VAS pain scores (Mean Difference [MD] = 0.56; 95% confidence interval [CI], 0.18 to 0.94; p = 0.004), six of the studies showed significantly improved WOMAC pain subscale scores (MD = 2.23; 95% CI, 0.56 to 3.91; p = 0.009), and 16 of the trials showed significantly improved total effectiveness rates (risk ratio = 1.12; 95% CI, 1.05 to 1.19; p = 0.0003). In addition, TCM showed a lower risk of adverse events than standard western treatments. This evidence suggests that TCM is safe and effective for improving pain, function, and wellness in treatments of knee OA. However, there is inherent clinical heterogeneity (diverse TCM formulations, controls, and treatment regimens) among the included trials. Despite these limitations, the potential analgesic effects of TCM warrant further methodologically rigorous research to determine the clinical implications of TCM on pain management in knee OA.
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              Management of knee osteoarthritis. Current status and future trends.

              Osteoarthritis (OA) affects a large number of the population, and its incidence is showing a growing trend with the increasing life span. OA is the most prevalent joint condition worldwide, and currently, there is no functional cure for it. This review seeks to briefly overview the management of knee OA concerning standardized pharmaceutical and clinical approaches, as well as the new biotechnological horizons of OA treatment. The potential of biomaterials and state of the art of advanced therapeutic approaches, such as cell and gene therapy focused primarily on cartilage regeneration are the main subjects of this review. Biotechnol. Bioeng. 2017;114: 717-739. © 2016 Wiley Periodicals, Inc.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                February 2019
                15 February 2019
                : 98
                : 7
                : e14510
                Affiliations
                [a ]Department of Emergency Surgery, First Affiliated Hospital of Jiamusi University
                [b ]Department of Hematology, Jiamusi Hospital of Traditional Chinese Medicine
                [c ]Department of Chinese Medicine, First Affiliated Hospital of Jiamusi University, Jiamusi
                [d ]First Ward of Orthopedics Department, Inner Mongolia Xilin Gol League Hospital, Xilinhot, China.
                Author notes
                []Correspondence: Zhi-ling Hou, Department of Emergency Surgery, First Affiliated Hospital of Jiamusi University, No. 348 Dexiang Street, Jiamusi, 154002, China (e-mail: zhiling198303@ 123456outlook.com ).
                Article
                MD-D-19-00601 14510
                10.1097/MD.0000000000014510
                6408025
                30762784
                a65f9124-ddfd-4966-ac35-2755dc394481
                Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 21 January 2019
                : 22 January 2019
                Categories
                3800
                Research Article
                Study Protocol Systematic Review
                Custom metadata
                TRUE

                duohuojisheng decoction,efficacy,knee osteoarthritis,randomized controlled trial,safety

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