五苓散加减治疗痛风及高尿酸血症对血尿酸值的Meta分析与系统评价  

Meta-analysis and Systematic Review of Uric Acid in the Treatment of Gout or Hyperuricemia with Wuling Powder

作　　者：王海金 刘湘玲[1] 吕仕超[1] 马兰 WANG Haijin;LIU Xiangling;LU Shichao;MA Lan(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：《中医药临床杂志》2021年第8期1488-1493,共6页Clinical Journal of Traditional Chinese Medicine

基　　金：天津市卫生和计划生育委员会中医;中西医结合科研课题(No:2017113)。

摘　　要：目的:评价五苓散加减对比降尿酸药物治疗痛风性关节炎及高尿酸血症的临床疗效和对血尿酸的影响。方法:计算机检索中国知网、万方数据库、超星期刊、中国生物医学文献网(CBM)、维普期刊数据库、PubMed数据库、Cochrane图书馆、Web of Science,纳入五苓散加减对照降尿酸药物治疗痛风及高尿酸血症的随机对照试验(RCT)文献。依据Cochrane系统评价员手册进行偏倚风险评估,使用RevMan 5.3及R语言统计软件对临床疗效、血尿酸值进行Meta分析。结果:共纳入8篇RCT文献,五苓散加减治疗痛风及高尿酸血症临床疗效的合并效应量RR=1.14,95%CI为(1.04,1.26),有统计学意义;治疗后尿酸值合并效应量的加权均数差值(SMD)的合并效应量-0.07μmol/L(-0.68,0.54)μmol/L,无统计学意义。安全性方面五苓散加减除了轻度腹泻,无明显不良反应。结论:五苓散加减治疗痛风及高尿酸血症有更好的临床疗效,同时具有降尿酸作用,且在安全性上不良反应发生率低,适合临床推荐。但由于纳入的文献质量不高,仍需高质量大样本RCT研究。Objective:To evaluate the clinical efficacy of Wulingsan modified and subtracted versus uric acid-lowering drugs in the treatment of gouty arthritis and hyperuricemia and its effect on blood uric acid.Methods:Computer search of China HowNet,Wanfang Database,Chaoxing Journal,China Biomedical Literature Network (CBM),Weipu Journal Database,PubMed Database,Co chrane Library,Web of Science,including Wulingsan plus or minus control for reducing uric acid Randomized controlled trials (RCT) literature on drug treatment of gout and hyperuricemia.According to the Cochrane System Reviewer’s Manual,the risk of bias was assessed,and the clinical efficacy and blood uric acid were meta-analyzed using RevMan 5.3 and R language statistical software.Results:A total of 8 RCT literatures were included.The combined effect size of the clinical efficacy of Wulingsan for gout and hyperuricemia was RR=1.14,95%CI was (1.04,1.26),which was statistically significant;Uric acid value after treatment The combined effect size of the weighted mean difference (SMD) of the combined effect size was-0.07μmol/L (-0.68,0.54)μmol/L,which was not statistically significant.In terms of safety,Wulingsan has no obvious adverse reactions except for mild diarrhea.Conclusion:Wuling powder has a better clinical effect in the treatment of gout and hyperuricemia,and has the effect of lowering uric acid,and has a low incidence of adverse reactions in terms of safety,which is suitable for clinical recommendation.However,due to the low quality of the included literature,high-quality large-sample RCT studies are still needed.

关 键 词：五苓散 经方 痛风 尿酸 系统评价 META分析 

分 类 号：R289.5[医药卫生—方剂学]