中成药软膏治疗湿疹的系统评价  

Systematic evaluation on the treatment of eczema with Chinese medicinal ointment

作　　者：杨志波[1] 赖彬[1] 黄迎玉[1] 

机构地区：[1]湖南中医药大学第二附属医院皮肤科,长沙410005

出　　处：《国际中医中药杂志》2011年第1期48-51,共4页International Journal of Traditional Chinese Medicine

基　　金：国家“十一五”科技支撑计划课题（项目编号：2008BA153B042）

摘　　要：目的 系统分析中成药软膏治疗湿疹的有效性、安全性,以期做出客观、可信的评价,指导临床研究.方法 计算机检索VIP数据库（1989～2008）、CHKD（1994～2008）,纳入以湿疹患者为研究对象、比较中成药软膏与西药洗剂疗效的随机对照试验,评价纳入研究的质量,采用Jadad量表记分法,并用RevMan4.2.7进行Meta分析.结果 共纳入11个随机对照试验共计1461例患者.Meta分析显示：①异质性检验：固定效应模型分析发现Q=16.57,P=0.08〉0.05,表明研究间的效应量是同质的.②合并效应量OR合并=0.41,95%的置信区间为[0.29,0.58].③x2=5.04（P〈0.01）,总体OR合并有统计学意义,说明中成药软膏临床有效率明显高于西药对照组.结论 中成药软膏治疗湿疹是一种有效的方法,且未发现较重的副作用.但由于存在发表偏倚和普遍低质量的随机对照试验,而致结论的可信度降低.Objective To systematically analyze the effectiveness and security of Chinese medicinal ointment treating eczema for the purpose of making an objective and creditable evaluation and guiding clinical usage. Methods Data in the VIP database （1989-2008） and CHKD （1994-2008） were researched and literatures on the treatment of eczema were included. Randomized control trails （RCTs） of therapeutic effects were compared between Chinese medicinal ointment and western medical treatment. Jadad Scale was adopted and RevMan4.2.7 was used to conduct Мeta analysis. Results 11 RCTs were adopted, including 1415 cases.① Heterogeneity Test： It was found through analysis with fixed effect model that Q= 16.57, and P=0.08〉0.05,which indicated that the effective between studies are homogenous. ② Total effect size＇ ORunited was 0.17,with the 95% confidence interval [0.29,0.58]. ③ x2=5.04 （P〈0.01）, P〈0.05, the total ORunited had statistic significance, which indicated that the treatment of eczema with the Chinese Medicinal Ointment was obviously better than that of western medicinal Ointment. Conclusion It is a effective method to treat eczema with Chinese Medicinal Ointment, and there is no serious ADR. However, because of publication bias and RCTs of universal lower quality, the credibility of the conclusion was reduced.

关 键 词：中成药软膏 湿疹 随机对照试验 META分析 发表性偏倚 

分 类 号：R27[医药卫生—中医学]