中药复方治疗肥胖症疗效的随机对照试验Meta分析  

Meta-analysis of clinical efficacy of Chinese herbal formulas on obesity based on randomized controlled trials

作　　者：刘珍秀 秦利[2] 黄怡文[1] 朱烨琳 陶枫[1] LIU Zhenxiu;QIN Li;HUANG Yiwen;ZHU Yelin;TAO Feng(Department of Endocrinology,Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Department of Endocrinology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海中医药大学附属市中医医院内分泌科,上海200071 [2]上海交通大学医学院附属新华医院内分泌科,上海200092

出　　处：《上海中医药杂志》2023年第2期26-34,共9页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81774237);上海申康医院发展中心临床科技创新项目(SHDC12018X27);上海市卫健委进一步加快中医药传承创新发展三年行动计划项目(ZY〔2021-2023〕-0105);上海中医药大学附属市中医医院未来计划项目(WL-XJRY-2021001K,WLJH2021ZY-GZS005)。

摘　　要：目的系统评价中药复方治疗肥胖症的有效性和安全性。方法计算机检索中国知网(CNKI)、维普中文期刊服务平台(VIP)、万方数据知识服务平台(WanFang Data)、中国生物医学文献服务平台(CBM)、PubMed、Cochrane、AMED、CINAHL、ClinicalTrials、Embase、Informit、ProQuest、SciFinder、Scopus、Web of Science等中英文数据库中收录的中药复方治疗肥胖症的相关文献(随机对照试验),文献发表时间为建库至2022年7月30日。采用Cochrane系统偏倚风险工具评估文献质量,借助RevMan5.4软件进行Meta分析。结果①最终纳入25篇文献,涉及2472例肥胖症患者,其中中药复方组1255例、对照组1217例。②与对照组相比,中药复方组能更好地降低肥胖症患者的体质量[MD=-3.05,95%CI(-4.64,-1.46)]和体质量指数[MD=-1.19,95%CI(-1.55,-0.82)],差异有统计学意义(P<0.05)。③进一步分析,与安慰剂比较,中药复方降低肥胖症患者体质量[MD=-3.22,95%CI(-5.78,-0.66)]及体质量指数[MD=-1.02,95%CI(-1.73,-0.31)]的作用更为显著;与生活方式干预比较,中药复方降低肥胖症患者体质量[MD=-3.91,95%CI(-5.49,-2.32)]及体质量指数[MD=-1.52,95%CI(-1.99,-1.05)]的作用更为显著;与西药比较,中药复方降低肥胖症患者体质量[MD=-2.89,95%CI(-6.47,0.69)]及体质量指数[MD=-1.18,95%CI(-1.68,-0.68)]的作用更为显著。以上差异均有统计学意义(P<0.05)。④亚组分析发现,与自拟方相比,经方对肥胖症具有更好的疗效[经方亚组体质量MD=-4.74,95%CI(-5.11,-4.36);自拟方亚组体质量MD=-2.19,95%CI(-4.63,0.25)];与辨病论治相比,辨证论治肥胖症疗效更佳[辨证论治亚组体质量MD=-4.99,95%CI(-7.13,-2.85);辨病论治亚组体质量MD=-1.21,95%CI(-4.12,1.69)]。以上差异均有统计学意义(P<0.05)。⑤纳入的25篇文献均未报道严重不良反应。结论中药复方是治疗肥胖症的有效方法,安全性良好,比较理想的应用模式为基于经方和辨证论治的处方用药�Objective To systematically evaluate the efficacy and safety of Chinese herbal formulas(CHFs)for obesity.Methods Literature related to the treatment of obesity with Chinese herbal formulas(randomized controlled trials)was included by searches conducted on China National Knowledge Infrastructure(CNKI),VIP Journal Integration Platform(VIP),Wanfang Data Knowledge Service Platform(WanFang Data),China Biomedical Literature Service System(CBM),PubMed,Cochrane,AMED,CINAHL,ClinicalTrials,Embase,Informit,ProQuest,SciFinder,Scopus,Web of Science and other Chinese and English databases,and the literature was published from the establishment of databases to July 30th,2022.Quality of studies was assessed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials and meta-analysis was performed with RevMan v5.4.Results①A total of 25 Random Clinical Trials(RCTs)involving 2,472 patients were included,1,225 patients in the CHF group and 1,217 in the control group.②Meta-analysis results showed that the CHF group had a better effect on lowering body weight[MD=-3.05,95%CI(-4.64,-1.46),P<0.05]and body mass index(BMI)[MD=-1.19,95%CI(-1.55,-0.82),P<0.05]of patients than the control group.③According to the further analysis,the CHM had a more significant effect on reducing body weight[MD=-3.05,95%CI(-4.64,-1.46)]and BMI[MD=-1.02,95%CI(-1.73,-0.31)]of patients than the placebo;The CHM had a more significant effect on reducing body weight[MD=-3.91,95%CI(-5.49,-2.32)]and BMI[MD=-1.52,95%CI(-1.99,-1.05)]of patients than the lifestyle intervention;The CHM had a more significant effect on reducing body weight[MD=-2.89,95%CI(-6.47,0.69)]and BMI[MD=-1.18,95%CI(-1.68,-0.68)]of patients than western drugs;and all of the above differences were statistically significant(P<0.05).④Subgroup analysis revealed that the classical formulas had better efficacy on obesity than the self-formulated formulas[classical formulas subgroup body weight MD=-4.74,95%CI(-5.11,-4.36),selfformulated formulas subgroup body weight MD=

关 键 词：肥胖症 中药复方 辨证论治 经典名方 随机对照试验 Meta分析 

分 类 号：R259[医药卫生—中西医结合]