Clinical Evidence Analysis Of Patelomalacia Treated By Traditional Chinese Medicine Based On Evidence-based Medicine

Objective:The literature on the treatment of patelomalacia with traditional Chinese medicine was systematically collected,reviewed and evaluated,and the quality,value and clinical guiding significance of the literature were summarized and summarized.To analyze the efficacy and safety evidences in the existing randomized controlled trials of traditional Chinese medicine in the treatment of patelomalacia and find its advantages and disadvantages.Methods:Using computer network information retrieval China hownet,journal of Chinese service platform,service system,a database of ten thousand Chinese biomedical literature,such as PubMed,Embase and Cochrane database database database in both English and Chinese from the building to August 3 1,2020,all randomized controlled trials about TCM treatment of patella softening with literature.Endnote X9 software was used to further analyze and double-check the comprehensively retrieved literatures,and then the literatures were screened according to inclusion criteria and exclusion criteria.Data were extracted by Endnote X9 and Excel 2018 software.The efficacy indicators of the included randomized controlled trials were analyzed for heterogeneity,effect value combination,sensitivity and funnel plot.The risk of bias was evaluated by Reviews Manger 5.3.5 software and Cochrane bias risk assessment tool.Results:A total of 18 clinical randomized controlled trials were included,involving 1546 subjects.There were no high-risk studies in all the included literatures,the overall quality of the literatures was relatively good,and the literatures had high credibility,and there was no significant publication bias.Meta-analysis results showed that the efficacy of traditional Chinese medicine treatment for patelomalacia was superior to conventional western medicine treatment.(1)The total effective rate of clinical efficacy RR(95%CI)=1.30[1.23,1.37],P<0.00001,the total effective rate of the Chinese medicine treatment group was significantly better than that of the western medicine conventional conservative treatment group,the difference was statistically significant.(2)Clinical efficacy cure rate RR(95%CI)=1.34[1.08,1.66],P=<0.00001;Significant efficiency RR(95%CI)=1.09[0.96,1.24],P=0.18;Effective RR(95%CI)=0.96[0.76,1.22],P=0.76.The results showed that the cure rate of the TCM treatment group was significantly better than that of the western conventional conservative treatment group,the difference was statistically significant.There was no significant difference in apparent efficiency and effective rate between the two groups.(3)The VAS score of the TCM treatment group was significantly lower than that of the western conventional conservative treatment group(SMD(95%CI)=-3.10[-4.96,-1.24],P=0.001,the difference was statistically significant.(4)Chinese medicine treatment in WOMAC scoring scale showed that pain SMD(95%CI)=-1.41[-1.74,-1.07],P<0.00001;Stiffness SMD(95%CI)=-1.66[-2.01,-1.31],P<0.00001;Dysmenorrhea SMD(95%CI)=-2.10[-3.05,-1.15],P<0.0001;Total score SMD(95%CI)=-3.62[-2.75,-1.58],P<0.00001.Traditional Chinese medicine was superior to conventional western medicine in pain,stiffness,daily function and total score,and the differences were statistically significant.Conclusion:The results of Meta analysis showed that the clinical efficacy of traditional Chinese medicine in the treatment of patelomalacia was better than conventional conservative treatment of western medicine.TCM treatment can improve the total effective rate and cure rate after treatment,and reduce the pain,stiffness,daily function and total score in VAS score and WOMAC score.TCM treatment of patelomalacia has some advantages,and relatively safe,worthy of further standardized promotion and application in clinical practice.