桂枝芍药知母汤治疗类风湿性关节炎Meta分析  

Meta-analysis of the Clinical Efficacy of Treating Rheumatoid Arthritis with Guizhi Shaoyao Zhimu Decoction

作　　者：潘建翔 董龙聪 王刚 付盈悦 彭科志[1] PAN Jianxiang;DONG Longcong;WANG Gang;FU Yingyue;PENG Kezhi(Guiyang College of Traditional Chinese Medicine,Guizhou Guiyang 550000,China)

机构地区：[1]贵州省贵阳中医学院,贵州贵阳550000

出　　处：《中医药临床杂志》2018年第10期1833-1840,共8页Clinical Journal of Traditional Chinese Medicine

摘　　要：目的:系统评价桂枝芍药知母汤治疗RA的临床疗效。方法:计算机检索数据库PubMed、EMbase、中国知网(CNKI)、维普数据库(VIP)及万方数据库(WANFANG),以桂枝芍药知母汤治疗RA的临床随机对照试验(RCT)为研究对象,设置检索时间为建库至2018年4月。通过两位研究员独立筛选文献,提取文献资料及评估偏倚风险并采用RevMan5.3软件对数据进行分析。结果:共纳入22个RCT研究,总样本量为1784例,其中试验组922例,对照组862例。Meta分析结果显示:桂枝芍药知母汤治疗RA的有效率优于常规西药治疗[RR=1.18,95%CI(1.13,1.23),P<0.00001],且桂枝芍药知母汤组在血沉[WMD=-5.01,95%CI(-7.86,-2.17),P=0.0005]、C反应蛋白[WMD=-3.27,95%CI(-4.93,-1.61),P=0.0001]、晨僵时间[WMD=-16.24,95%CI(-20.52,-11.96),P<0.00001]、关节肿胀指数[WMD=-0.32,95%CI(-0.45,-0.20),P<0.00001]等指标改善均优于常规西药。纳入的研究有8个提及不良反应。结论:桂枝芍药知母汤治疗RA较常规西药疗效更优,但现有临床研究存在数量少,质量低等问题的限制,需要开展更多高质量,大样本,多中心的临床随机双盲研究验证。Objective： To evaluate the effect of Guizhi Shaoyao Zhimu decoction in the treatment of rheumatoid ar- thritis. Menthods： PubMed, EMbase, CNKI, VIP and WANFANG were searched to collect randomized controlled tri- als on the treatment of rheumatoid arthritis with Guizhi Shaoyao Zhimu decoction from inception to April, 2018.Two reviewers independently screened the literature, extracted data, assessed the risk of bias of included studies and ana- lyzed date by using RevMan5.3 software.Results： Twenty-two RCTs were involving 1784 cases were included.Among them, 922 cases were belonged to Guizhi Shaoyao Zhimu decoction group and Western medicine group was included 862 cases.The results of Meta-analysis indicated that in efficiency rate[RR=1.18, 95%CI（1.13, 1.23）, P〈0.00001], ESR[WMD=-5.01, 95%CI（-7.86, -2.17）, P=0.O005], CRP [WMD=-3.27, 95%CI （-4.93, -1.61）, P=0.0001], morning stiff time[WMD=-16.24, 95%CI （-20.52, -11.96）, P〈0.00001] and joint swelling index[WMD=-0.32, 95%CI （-0.45, -0.20）, P〈0.00001], Guizhi Shaoyao Zhimu decoction group were all better then western medicine group.There were eight research that reported untoward effect.Conclusion： The Guizhi Shaoyao Zhimu decoction for rheumatoid arthritis has distinct advantage comparing with western medicine. However, there are some limitations in clinical studies, such as low quantity and low quality, so it is necessary to carry out more randomized double-blind clinical studies with high qualitv, large sample and multi-center.

关 键 词：桂枝芍药知母汤 类风湿性关节炎 META分析 系统评价 

分 类 号：R259[医药卫生—中西医结合]