RESUMO
OBJECTIVE: The objective of the study is to systematically analyze the safety and efficacy of radiofrequency ablation (RFA) therapy for the treatment of patients with knee osteoarthritis (KOA) and to assess the methodological quality of the published studies. METHODS: By searching the PubMed, Embase, and CENTRAL databases, we retrieved and collected relevant randomized controlled trials (RCTs) published up to June 26, 2023. RESULTS: We included 13 RCTs, involving a total of 865 patients. Compared with the control group, the RFA group had significantly reduced pain scores at 1-2 weeks, 4 weeks, 12 weeks, and 24 weeks post-treatment, with standardized mean differences of -1.24 (95% confidence interval [CI]: -1.99--0.49; p = 0.001; I2 = 91%), -0.76 (95% CI: -1.27--0.26; p = 0.003; I2 = 76%), -1.70 (95% CI: -2.56--0.83; p = 0.0001; I2 = 94%), and -2.26 (95% CI: -3.49--1.04; p = 0.0003; I2 = 95%). CONCLUSIONS: RFA, as an adjunctive treatment modality, demonstrates potential in the treatment of patients with KOA. This method may become a primary treatment strategy for these patients.
OBJETIVO: Analizar sistemáticamente la seguridad y la eficacia de la ablación por radiofrecuencia en pacientes con osteoartritis de rodilla y evaluar la calidad metodológica de los estudios publicados. MÉTODO: Mediante una búsqueda en las bases de datos PubMed, EMBASE y CENTRAL, recuperamos y recopilamos los ensayos aleatorizados controlados relevantes publicados hasta el 26 de junio de 2023. RESULTADOS: Se incluyeron 13 ensayos aleatorizados controlados que involucraron a 865 pacientes. En comparación con el grupo control, el grupo de ablación por radiofrecuencia registró una reducción significativa en la puntuación de dolor a 1-2 semanas, 4 semanas, 12 semanas y 24 semanas del tratamiento, con una diferencia media estandarizada de −1.24 (intervalo de confianza del 95% [IC95%]: −1.99 a −0.49; p = 0.001; I2 = 91%), de −0.76 (IC95%: −1.27 a −0.26; p = 0.003; I2 = 76%), de −1.70 (IC95%: −2.56 a − 0.83; p = 0.0001%; I2 = 2.94%) y de 2.26 (IC95%: −3.49 a −1.04; p = 0.0003; I2 = 95%), respectivamente. CONCLUSIONES: La ablación por radiofrecuencia como tratamiento adyuvante muestra potencial en el tratamiento de pacientes con osteoartritis de rodilla. Este método puede convertirse en la principal estrategia terapéutica para estos pacientes.
Assuntos
Osteoartrite do Joelho , Ablação por Radiofrequência , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Osteoartrite do Joelho/cirurgia , Ablação por Radiofrequência/métodos , Resultado do Tratamento , Medição da DorRESUMO
Nonalcoholic fatty liver disease (NAFLD) is considered to be a manifestation of hepatic metabolic syndrome. Some studies on the pathogenesis of NAFLD by targeting gut microbiota have attracted wide attention. Previous studies have demonstrated the positive effects of berberine and evodiamine on metabolic diseases and gut microbiota dysbiosis. However, it is not known whether the combination of berberine and evodiamine (BE) can prevent the development of high-fat diet (HFD)-induced NAFLD. Therefore, we aimed to explore the protective effects of BE on the development of HFD-induced NAFLD from the perspective of the gut microbiota. Gut microbiota profiles were established by high throughput sequencing of the bacterial 16S ribosomal RNA gene. The effects of BE on liver and intestinal tissue, intestinal barrier integrity, and hepatic inflammation were also investigated. The results showed that the abundance and diversity of gut microbiota were enriched by BE treatment, with an increase in beneficial bacteria, such as Lactobacillus, Ruminococcus, and Prevotella, and a decrease in pathogenic bacteria such as Fusobacterium and Lachnospira. In addition, BE effectively improved liver fat accumulation and tissue damage, inhibited the apoptosis of intestinal epithelial cells, increased the contents of intestinal tight junction proteins, and decreased the expression of pro-inflammatory factors. Consequently, BE treatment could be an effective and alternative strategy for alleviating NAFLD by modulating gut microbiota and safeguarding the intestinal barrier.
Assuntos
Berberina , Microbioma Gastrointestinal , Hepatopatia Gordurosa não Alcoólica , Animais , Berberina/metabolismo , Berberina/farmacologia , Berberina/uso terapêutico , Dieta Hiperlipídica/efeitos adversos , Fígado/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Hepatopatia Gordurosa não Alcoólica/metabolismo , Quinazolinas , RatosRESUMO
Nonalcoholic fatty liver disease (NAFLD) is considered to be a manifestation of hepatic metabolic syndrome. Some studies on the pathogenesis of NAFLD by targeting gut microbiota have attracted wide attention. Previous studies have demonstrated the positive effects of berberine and evodiamine on metabolic diseases and gut microbiota dysbiosis. However, it is not known whether the combination of berberine and evodiamine (BE) can prevent the development of high-fat diet (HFD)-induced NAFLD. Therefore, we aimed to explore the protective effects of BE on the development of HFD-induced NAFLD from the perspective of the gut microbiota. Gut microbiota profiles were established by high throughput sequencing of the bacterial 16S ribosomal RNA gene. The effects of BE on liver and intestinal tissue, intestinal barrier integrity, and hepatic inflammation were also investigated. The results showed that the abundance and diversity of gut microbiota were enriched by BE treatment, with an increase in beneficial bacteria, such as Lactobacillus, Ruminococcus, and Prevotella, and a decrease in pathogenic bacteria such as Fusobacterium and Lachnospira. In addition, BE effectively improved liver fat accumulation and tissue damage, inhibited the apoptosis of intestinal epithelial cells, increased the contents of intestinal tight junction proteins, and decreased the expression of pro-inflammatory factors. Consequently, BE treatment could be an effective and alternative strategy for alleviating NAFLD by modulating gut microbiota and safeguarding the intestinal barrier.