The Efficacy and Safety of Zhengqing Fengtongning for Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
Bibliographic record
Abstract
Background. Zhengqing Fengtongning release tablet (ZQFTN) is a proprietary Chinese medicine preparation of sinomenine, the main active component of the traditional Chinese medicine (TCM) Sinomenium acutum. It is used in China as a complementary and alternative medicine (CAM) for knee osteoarthritis (KOA). The objective of this study was to evaluate the clinical efficacy and safety of ZQFTN in KOA treatment. Method. Randomized controlled trials of ZQFTN in KOA treatment were searched in PubMed, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database, and Wanfang database. Two reviewers independently conducted the screening, extracted the data, and assessed the methodological quality. Statistical analysis was performed using RevMan 5.3 software. Results. Eighteen studies were assessed that included 1512 participants (757 in the treatment group and 755 in the control group). The results showed that compared with the control group, the Visual Analogue Scale (standardized mean difference (SMD) = −0.87, 95% confidence interval (CI): [−1.08, −0.66], <math xmlns="http://www.w3.org/1998/Math/MathML" id="M1"> <mi>P</mi> <mo><</mo> <mn>0.001</mn> </math> ), Western Ontario and Mc Master University (WOMAC) Osteoarthritis Index pain score (SMD = −0.67, 95% CI: [−0.88, −0.46], <math xmlns="http://www.w3.org/1998/Math/MathML" id="M2"> <mi>P</mi> <mo><</mo> <mn>0.001</mn> </math> ), WOMAC stiffness score (SMD = −0.53, 95% CI: [−0.86, −0.20], <math xmlns="http://www.w3.org/1998/Math/MathML" id="M3"> <mi>P</mi> <mo>=</mo> <mn>0.001</mn> </math> ), WOMAC function score (SMD = −0.76, 95% CI: [−0.97, −0.55], <math xmlns="http://www.w3.org/1998/Math/MathML" id="M4"> <mi>P</mi> <mo><</mo> <mn>0.001</mn> </math> ), serum interleukin-1β level (SMD = −4.36, 95% CI: [−6.41, −2.31], <math xmlns="http://www.w3.org/1998/Math/MathML" id="M5"> <mi>P</mi> <mo><</mo> <mn>0.001</mn> </math> ), and serum tumor necrosis factor-α level (SMD = −8.45, 95% CI: [−11.20, −5.69], <math xmlns="http://www.w3.org/1998/Math/MathML" id="M6"> <mi>P</mi> <mo><</mo> <mn>0.001</mn> </math> ) of the ZQFTN treatment group were lower, and the total effective rate was higher relative risk (RR = 1.15, 95% CI [1.07, 1.23], <math xmlns="http://www.w3.org/1998/Math/MathML" id="M7"> <mi>P</mi> <mo><</mo> <mn>0.001</mn> </math> ). There was no significant difference in the incidence of adverse reactions between the two groups (RR = 0.96, 95% CI: [0.69, 1.35], <math xmlns="http://www.w3.org/1998/Math/MathML" id="M8"> <mi>P</mi> <mo>=</mo> <mn>0.82</mn> </math> ). Conclusion. ZQFTN can effectively relieve knee pain, morning stiffness, and daily activity function disorders, reduce the expression of inflammatory factors in serum, and improve the total clinical response rate without increasing the incidence of adverse reactions. Therefore, ZQFTN has considerable potential as a CAM for KOA. However, due to the limitation of the quality of the included studies, the strength of this conclusion is affected. In the next step, multicenter, large sample, high-quality randomized controlled studies are needed to further confirm the present conclusion.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.037 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.026 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".