Risk Factors Of Knee Osteoarthritis Complicated With Osteoporosis And Meta-analysis Of Integrated Traditional Chinese And Western Medicine Treatment

Objective: To explore the relevant risk factors of KOA complicated with OP,and provide reference for the prevention and treatment of KOA complicated with OP.Through the systematic evaluation of the clinical effectiveness and safety of the treatment of KOA patients with OP by integrated traditional chinese and western medicine.Methods: Retrospective collection of patients with knee osteoarthritis admitted to orthopedic department of our hospital from January 1,2021 to December 31,2022.According to OP diagnostic criteria,patients were divided into two groups(op group and non-op group).According to the inclusion criteria and exclusion criteria of this study,36 KOA patients complicated with OP were set as observation group.For each op case,2 non-op controls were selected from those KOA patients without OP.The baseline data and laboratory data of the two groups of patients were analyzed by univariate and multivariate logistic regression.The randomized controlled trials of traditional chinese medicine combined with western medicine in treatment of KOA complicated with OP that meet the inclusion criteria in the database(CNKI,Wanfang,Vip,Sino Med,Pub Med,Embase)from the establishment of the database to november 2022 were retrieved,according to the inclusion criteria and exclusion criteria developed in this study,qualified documents were screened,and the specific literature data of each included study were recorded.Using the cochrane bias risk assessment tool to evaluate the quality of study.Using the review manager 5.4.1 software to evaluate bone mineral density,VAS score,total effective rate,serum β-CTX content,blood calcium content,WOMAC score and incidence of adverse reactions.Results: In this study,there were significant differences in height,albumin,BMI,weight,gender,uric acid,blood phosphorus,lymphocyte count,total protein,hemoglobin,alanine aminotransferase,age,blood calcium,aspartate aminotransferase between the two groups(P<0.05),but there was no significant difference in creatinine,fasting blood glucose,total bilirubin and alkaline phosphatase(P>0.05).Univariate logistic regression analysis showed that age,hemoglobin,sex,BMI,height,weight,lymphocyte count,albumin,total protein,uric acid,blood calcium,alanine aminotransferase,blood phosphorus,aspartate aminotransferase may be related to the risk factors of KOA complicated with OP(P<0.05).Multivariate logistic regression analysis showed that patients with KOA who were older{OR:1.397,95% CI:(1.11,1.757),P=0.004}and lower hemoglobin concentration {OR:0.789628,95%CI:(0.646,0.965),P=0.021} had a higher risk of osteoporosis.In addition,patients with knee osteoarthritis with higher alanine aminotransferase also have a higher risk of osteoporosis {OR:1.21,95%CI:(1.002,1.461),P=0.048}.Therefore,old age,anemia and high alanine aminotransferase are independent risk factors of knee osteoarthritis with osteoporosis.12 RCTs were included,the total sample size involved 1062 patients,there are 531 patients in the treatment group and 531 patients in the control group.Meta analysis showed that traditional Chinese medicine combined with western medicine improved the total effective rate [OR:4.57,Z=7.50,95% CI:(3.07,6.80),P<0.00001],decreased VAS score [MD:-0.96,Z:28.13,95% CI:(-1.03,-0.89),P<0.00001],increased lumbar bone density[SMD:0.43,Z=2.98 95% CI :(0.15,0.71),P=0.003],increased femoral neck bone density [MD=0.03,Z=3.31,95% CI:(0.01,0.04),P=0.0009],and decreased serum β-CTX content [SMD:-0.75,Z=5.16,95% CI:(-1.04,-0.47),P<0.00001],increased blood calcium content [MD:1.42,Z:3.02,95%CI:(0.50,2.35),P=0.003],decreased WOMAC score [MD:-7.71,Z:5.46,95%CI:(-10.47,-4.94),P =0.0001] is better than western medicine treatment,and there is no difference in adverse reactions [OR:0.77,Z:0.44,95% CI :(0.24,2.45),P=0.66].Conc Iusion: Anemia,old age and high alanine aminotransferase are independent risk factors of KOA complicated with OP.The treatment of KOA complicated with OP by integrated traditional chinese and western medicine not only significantly increased blood calcium content,the total effective rate,femoral neck bone mineral density,lumbar bone mineral density,but also significantly decreased WOMAC score,VAS score and serum β-CTX content;In terms of safety,there was no statistical difference in the incidence of adverse reactions between the two groups.