补肾强督法治疗强直性脊柱炎的Meta分析  

A Meta-analysis on Treatment of Ankylosing Spondylitis by Bushen Qiangdu Method

作　　者：李玉颖 王一凡 陈嘉杰 何羿婷[2] LI Yuying;WANG Yifan;CHEN Jiajie;HE Yiting(The Second Clinical School of Medicine of Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Department of Rheumatology,Traditional Chinese Medicine Hospital of Guangdong Province,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广州510006 [2]广东省中医院风湿科,广州510120

出　　处：《医学综述》2022年第16期3280-3290,共11页Medical Recapitulate

基　　金：国家自然科学基金(81673898)。

摘　　要：目的对补肾强督法治疗强直性脊柱炎(AS)的临床疗效进行系统评价。方法检索知网、万方、维普、CBM、PubMed、Embase、The Cochrane Library等数据库,筛选使用补肾强督法治疗AS的临床随机对照试验,检索日期为建库至2020年12月31日,运用RevMan 5.4软件对符合纳入和排除标准的研究进行质量评价及Meta分析。结果本研究共纳入13篇文献,共1067例患者,其中试验组533例,对照组534例。其中有6项研究的试验组给予补肾强督中药治疗,对照组给予西药治疗;另8项研究的试验组给予补肾强督中药联合西药治疗,对照组给予西药治疗,疗程为8~24周。Meta分析结果显示,中西药结合组和中药组在AS的疗效评价标准20达标数(RR=1.40,95%CI 1.11~1.76,P=0.004;RR=1.27,95%CI 1.10~1.47,P=0.001)、脊柱疼痛视觉模拟评分法评分(MD=-0.97,95%CI-1.25~-0.68,P<0.00001;MD=-1.33,95%CI-2.42~-0.24,P=0.02)、Bath AS功能指数(MD=-1.03,95%CI-1.66~-0.40,P=0.001;MD=-0.75,95%CI-1.26~-0.23,P=0.005)、Bath AS疾病活动指数(MD=-0.69,95%CI-1.06~-0.31,P=0.0003;MD=-0.97,95%CI-1.78~-0.16,P=0.02)、红细胞沉降率(MD=-5.97,95%CI-8.63~-3.30,P<0.0001;MD=-4.62,95%CI-7.11~-2.14,P=0.0003)、C反应蛋白(SMD=-1.39,95%CI-2.07~-0.71,P<0.0001;SMD=-0.46,95%CI-0.79~-0.14,P=0.005)改善情况方面均优于对照组。结论补肾强督法治疗AS的临床疗效肯定,但仍需要高质量、大样本和多中心的临床随机对照试验进行验证。Objective To systematically evaluate the clinical efficacy of Bushen Qiangdu(tonifying the kidney and strengthening the Du channel)method in the treatment of ankylosing spondylitis(AS).Methods The databases of CNKI,Wanfang,VIP,CBM,PubMed,Embase and The Cochrane library were searched to screen the clinical randomized controlled trials of Bushen Qiangdu method in the treatment of AS.The search date was from the establishment of the database to Dec.31st,2020.Revman 5.4 software was used to evaluate the quality and conduct a meta-analysis of the studies that met the inclusion and exclusion criteria.Results A total of 13 literatures were included in this study.1067 patients were observed,including 533 cases in the test group and 534 cases in the control group.In 6 studies,the test group was treated with traditional Chinese medicine for Bushen Qiangdu,and the control group was treated with western medicine;in the other 8 studies,the test group was treated with traditional Chinese medicine combined with western medicine,while the control group was treated with western medicine for 8-24 weeks.Meta-analysis results showed that,the combination group of Chinese and western medicine and Chinese medicine group in the number of efficacy evaluation criteria of AS 20(RR=1.40,95%CI 1.11-1.76,P=0.004;RR=1.27,95%CI 1.10-1.47,P=0.001),spinal pain visual analogue scale score(MD=-0.97,95%CI-1.25--0.68,P<0.00001;MD=-1.33,95%CI-2.42--0.24,P=0.02),Bath AS function index(MD=-1.03,95%CI-1.66--0.40,P=0.001;MD=-0.75,95%CI-1.26--0.23,P=0.005),Bath AS disease activity index(MD=-0.69,95%CI-1.06~-0.31,P=0.0003;MD=-0.97,95%CI-1.78--0.16,P=0.02),erythrocyte sedimentation rate(MD=-5.97,95%CI-8.63--3.30,P<0.0001;MD=-4.62,95%CI-7.11--2.14,P=0.0003),C-reactive protein(SMD=-1.39,95%CI-2.07--0.71,P<0.0001;SMD=-0.46,95%CI-0.79--0.14,P=0.005)improvement were better than the control group.Conclusion Bushen Qiangdu method is effective in the treatment of AS,but higher quality,larger sample size and multicenter randomized controlled clinical trials are still

关 键 词：强直性脊柱炎 补肾强督法 临床疗效 META分析 系统评价 

分 类 号：R593.23[医药卫生—内科学]