中药洗剂外治慢性湿疹有效性及安全性Meta分析  

Meta Analysis of Efficacy and Safety in External Treatment of Chronic Eczema with Traditional Chinese Medicine Lotions

作　　者：陈兴[1,2] 黄丽霞[2] 李忻红[2] 石晓婷 吴秋影 田静[1,2] CHEN Xing;HUANG Lixia;LI Xinhong;SHI Xiaoting;WU Qiuying;TIAN Jing(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医药大学学报》2021年第5期183-188,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：辽宁省自然科学基金(20180550212)。

摘　　要：目的通过Meta分析系统评价中药洗剂外治慢性湿疹的有效性和安全性。方法通过检索PubMed、Cochrane Library、Clinical Trials、中国知网(CNKI)、维普中文期刊服务平台(VIP)、万方数据知识服务平台(Wanfang)、中国生物医学文献服务系统(SinoMed),收集中药洗剂外治慢性湿疹的随机对照试验或半随机对照试验,采用Cocharne评价手册进行方法学质量评价,提取数据并运用Rev Man 5.3软件进行Meta分析,用漏斗图评估文献的发表偏倚。结果该研究共纳入31项临床试验(25项RCT,6项quasi-RCT),包括2899例患者,中药洗剂组总有效率优于西药组[RR=1.25,95%CI(1.18,1.33),P<0.00001],且对于不同类型患者的亚组分析提示,无论是未提及皮损具体部位的慢性湿疹组,还是手足、肛门肛周阴囊、外耳道慢性湿疹组,中药洗剂组的有效率均优于西药组,差异均具有统计学意义;复发率共纳入10项研究,涉及1063例患者,中药洗剂组总复发率低于西药组[RR=0.29,95%CI(0.20,0.43),P<0.00001],未提及皮损具体部位的慢性湿疹组、手足慢性湿疹组、肛周阴囊慢性湿疹组和外耳道慢性湿疹组的复发率,中药洗剂组均低于西药组,差异均具有统计学意义;所有研究未报道严重不良事件,17项研究报道了不良反应的发生情况。有效率漏斗图呈非对称性分布,提示存在发表偏倚。结论中药洗剂外治慢性湿疹具有较好的临床疗效及安全性,复发率低,但确切结论有待于多中心、大样本且高质量的随机对照试验证实。Objective To evaluate the efficacy and safety of traditional Chinese medicine(TCM)lotions in external treatment of chronic eczema by Meta analysis.Methods Randomized controlled trials(RCTs)or semi-randomized controlled trials(quasi-RCTs)in external treatment of chronic eczema with TCM lotions were collected by retrieval of PubMed,Cochrane Library,Clinical Trials,CNKI,VIP,WanFang and SinoMed.The Cocharne evaluation manual was used for methodological quality evaluation.Data were extracted and Meta analysis was performed using Rev Man 5.3 software.Funnel plots were used to evaluate publication bias.Results 31 were included in this study for clinical trials(25 RCTs,6 quasi-RCTs),including 2899 patients.The total effective rate of TCM lotion group was better than that of Western medicine group[RR=1.25,95%CI(1.18,1.33),P<0.00001],and for the subgroup analysis of different types of patients,whether the chronic eczema group without mentioning the specific site of skin lesions,or the chronic eczema groups of hands and feet,anus,crissum,scrotum and external auditory canal,the effective rate of the TCM lotion group was better than that of the Western medicine group,and the difference was statistically significant.A total of 10 studies were included in the recurrence rate,involving 1063 patients.The total recurrence rate of TCM lotion group was lower than that of Western medicine group[RR=0.29,95%CI(0.20,0.43),P<0.00001].Whether the chronic eczema group without mentioning the specific site of skin lesions,or the chronic eczema groups of hands and feet,crissum,scrotum and external auditory canal,the recurrence rate of the TCM lotion group was lower than that of the western medicine group,and the difference was statistically significant.None of the studies reported serious adverse events,and 17 studies reported the occurrence of adverse reactions.The distribution of the effective funnel plots was asymmetric,suggesting publication bias.Conclusion External treatment of chronic eczema with TCM lotions have good clinical efficacy,

关 键 词：慢性湿疹 中药洗剂 随机对照试验 META分析 

分 类 号：R758.23[医药卫生—皮肤病学与性病学]