白芍总苷联用免疫抑制剂治疗类风湿关节炎的Meta分析  

Meta-analysis of the Efficacy and Safety of Total Glucosides of Paeony Combined with Immunosuppressant in the Treatment of Rheumatoid Arthritis

作　　者：钟雪[1] 苏娜[2,3] 周世红[4] 杨南萍[1] 谢珍国[2] 

机构地区：[1]四川大学华西医院临床免疫科,成都市610041 [2]四川大学华西药学院,成都市610041 [3]四川大学华西医院药剂科,成都市610041 [4]四川大学华西公共卫生学院,成都市610041

出　　处：《中国药房》2010年第39期3731-3734,共4页China Pharmacy

摘　　要：目的:评价白芍总苷联用免疫抑制剂治疗类风湿关节炎患者的疗效与安全性。方法:计算机检索PubMed、CENTRAL、EMBASE、CBM、CNKI和中文科技期刊全文数据库(维普),均从建库日期检索至2009年10月,并追踪已获文献的参考文献,纳入白芍总苷和免疫抑制剂联用与单用相应免疫抑制剂的随机对照试验(RCT)。采用RevMan5.0软件进行Meta分析。结果:共纳入9个RCT,合计707例患者。Meta分析的亚组结果显示,治疗12周时的缓解率试验组优于对照组,其差异有统计学意义(RR=1.22,95%C[I1.08,1.38],P=0.002);安全性指标在治疗12周及48周结束时,其任意不良反应发生率试验组均低于对照组,分别为(RR=0.66,95%CI[0.48,0.92])和(RR=0.7,95%CI[0.57,0.86])。结论:白芍总苷和免疫抑制剂联用治疗类风湿关节炎可能在治疗早期较单用免疫抑制剂为佳;但受纳入文献质量影响,以上结论尚需高质量的临床试验进一步证实。OBJECTIVE：To evaluate the efficacy and safety of total glucosides of paeony（TGP）combined with immunosuppr-essant in the treatment of rheumatoid arthritis.METHODS：Retrieved from PubMed,CENTRAL,EMBASE,CBM,CNKI and VIP database（up to Oct.2009）,RCTs on TGP combined with immunosuppressant and immunosuppressant alone were included.Related references of included literatures were reviewed.Meta-analysis were conducted using RevMan 5.0 software.RESULTS：9 RCTs involving 707 patients were included.Meta-analysis results of subgroup showed the remission rate of trial group was better than that of control group after 12 weeks of treatment,there was statistical significance（RR=1.22,95%CI[1.08,1.38],P=0.002）.For safety,the incidences of any adverse drug reactions（ADRs） of trial group were lower that those of control group after 12 weeks of treatment（RR=0.66,95%CI[0.48,0.92]） and after 48 weeks of treatment（RR=0.7,95%CI[0.57,0.86]）.CONCLUSION：Therapy of TGP combined with immunosuppressant might be more effective and than immunosuppressant alone for rheumatoid arthritis in the early stage of treatment.High-quality and large-scale RCTs are needed to further prove the results of study because of the low quality of the included studies.

关 键 词：白芍总苷 免疫抑制剂 类风湿关节炎 META分析 系统评价 

分 类 号：R286[医药卫生—中药学] R969.4[医药卫生—中医学]