从毒论治痛风疗效及安全性的系统评价  

Systematic Evaluation of Efficacy and Safety of Treating Gout from Toxin

作　　者：刘维[1] 赵文甲 吴沅皞[1] LIU Wei;ZHAO Wenjia;WU Yuanhao(The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China)

机构地区：[1]天津中医药大学第一附属医院,天津300193

出　　处：《辽宁中医杂志》2020年第3期34-38,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81673927);天津市卫生和计划生育委员会中医中西医结合科研课题(2015092,2015091);天津市科技计划项目(15ZXLCSY00020)。

摘　　要：目的系统评价从毒论治痛风的临床疗效及安全性。方法收集从毒论治治疗痛风的临床随机对照试验。通过计算机检索Pub Med、EMbase、Cochrane图书馆、中国知网、维普数据和万方数据,查找有关应用从毒论治与西药治疗痛风的随机对照试验(randomized controlled trial,RCT),检索时限均从建库至2017年12月,使用Revman 5.3软件进行Meta分析。结果共纳入10个研究。Meta分析结果显示从毒论治疗法在有效率[RR=1.18,95%CI(1.11,1.26)],降低尿酸(blood uric acid,BUA)[SMD=-1.58,95%CI(-2.51,-0.66)],改善视觉模拟评分(visual analogue scale,VAS)[SMD=-1.27,95%CI(-2.43,-0.12)],及降低血沉(erythrocyte sedimentation rate,ESR)[SMD=-1.05,95%CI(-1.74,-0.37)]等方面差异有统计学意义,优于常规西药治疗。安全性方面,从毒论治中药不良反应低于对照组[RR=0.08,95%CI(0.01,0.49)]。结论本Meta分析结果显示,应用从毒论治疗法治疗痛风优于常规西药治疗,且安全性高,为痛风临床治疗提供了一个新的选择,但是由于纳入研究样本量较小,质量偏低,上述结论仍需大规模临床试验加以验证。Objective To systematically evaluate the clinical effect and safety of treating gout from toxin.Methods The randomized controlled trials(RCTs)were collected from Pub Med,EMbase,Cochrane library retrieval,China CNKI,Wanfang Data and VIP from inception to December 2017.Revman 5.3 software was used Meta-analysis.Results A total of 10 studies were included.The Meta-analysis results showed that based on detoxification therapy,the efficiency[RR=1.18,95%CI(1.11,1.26)],blood uric acid(BUA)[SMD=-1.58,95%CI(-2.51,-0.66)],visual analogue scale(VAS)[SMD=-1.27,95%CI(-2.43,-0.12)]and the decrease of the erythrocyte sedimentation rate(ESR)[SMD=-1.05,95%CI(-1.74,-0.37)]were statistically superior to those of the conventional Western medicine.In safety,the adverse reaction of traditional Chinese medicine was lower than that of the control group[RR=0.08,95%CI(0.01,0.49)].Conclusion The results of Meta-analysis showed that application of detoxification therapy in the treatment of gout is better than conventional western medicine treatment with high safety,and provided a new choice for the treatment of gout.But due to the small sample size,the quality is low and this conclusion still needs large-scale clinical trials to verify.

关 键 词：痛风 从毒论治 系统评价 META分析 

分 类 号：R684[医药卫生—骨科学]