雷公藤提取物治疗类风湿关节炎的Meta分析  

Tripterygium Wilfordii Extraction for Treating Rheumatoid Arthritis:a Meta-analysis

作　　者：杨坤[1] 吴东方[1] 程虹[1] 

机构地区：[1]武汉大学中南医院药学部,武汉430071

出　　处：《药物流行病学杂志》2016年第11期677-682,共6页Chinese Journal of Pharmacoepidemiology

摘　　要：目的:评价雷公藤提取物(Tw HF)治疗类风湿关节炎(RA)的疗效和安全性。方法:检索Pub Med、Medline、EMbase、Cochrane、CNKI、Sino Med及万方等数据库(时间截止至2016年5月),同时手工检索相关杂志和参考文献,选择符合标准的文献。按Cochrane系统评价方法,评价纳入研究的方法学质量评价并提取有效数据,采用RevMan5.2软件进行Meta分析。结果:共纳入10个随机对照试验(RCT),Tw HF与安慰剂相比,两组结局指标中的握力、关节肿胀及血清RF、急性时相反应物红细胞沉降率(ESR)的差异均有统计学意义(P<0.05);Tw HF与改善病情抗风湿药(DMARDs)比较,晨僵及类风湿因子(RF)的差异有统计学意义(P<0.05);Tw HF+DMARDs与DMARDs相比,关节肿胀及ESR的差异均有统计学意义(P<0.05);Tw HF+DMARDs与两种DMARDs联用比较,关节疼痛数(TJC)、关节肿胀数(SJC)、ESR及C-反应蛋白(CRP)的差异均有统计学意义(P<0.05)。结论:本系统评价提示Tw HF是缓解RA病情的有效药物,但Tw HF治疗RA的疗效和安全性尚需要高质量大样本RCT进一步验证。Objective：To evaluate systematically the clinical effectiveness and safety of Tripterygium wilfordii Hook F （TwHF） extract in the treatment of rheumatoid arthritis （RA）. Methods： Randomized controlled trials （RCTs） regarding RA treated by TwHF were searched in the PubMed, Medline, EMbase, Cochrane, CNKI, SinoMed and Wanfang databases. The Cochrane risk of bias method was used to assess the quality of included studies, and a Meta-analysis was conducted with Review Manager 5.2 software. Results： A total of 10 studies were enrolled, compared TwHF with placebo, tender joint count （TJC）, grip strength （GS）, RF and ESR of TwHF group were significant superior to that of control group （P 〈 0.05 ）. Compared TwHF with DMARDs, duration of morning stiffness （DMS） and RF were significant superior to that of DMARDs group （P 〈 0.05 ）. Compared TwHF plus DMARDs with DMARDs, swollen joint count （SJC） and ESR of TwHF plus DMARDs were significant superior to that of DMARDs group （ P 〈0. 05 ）. Compared TwHF plus DMARDs with 2 DMARDs combined group, TJC, SJC, ESR and CRP of TwHF plus DMARDs were significant superior to that of DMARDs combined group （ P 〈 0.05 ）. Conclusion： The therapeutic use of DH was effective for RA, but high quality double-blinded RCTs with larger samples were needed for a further analysis.

关 键 词：雷公藤提取物 类风湿关节炎 META分析 

分 类 号：R593.22[医药卫生—内科学]