针刺联合甲氨蝶呤治疗类风湿关节炎的疗效及安全性Meta分析  

Meta-analysis of Efficacy and Safety of Acupuncture Combined with Methotrexate in Treatment of Rheumatoid Arthritis

作　　者：陈家涟 朱田田[1] 杨东宇 赵中亭[1] CHEN Jialian;ZHU Tiantian;YANG Dongyu;ZHAO Zhongting(Gansu University of Chinese Medicine,Lanzhou 730000,Gansu,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730000

出　　处：《实用中医内科杂志》2023年第9期31-34,I0005,I0006,共6页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家自然科学基金(82060892);国家自然科学基金地区项目(81560791);甘肃省高等学校青年博士基金项目(2022QB-095);甘肃中医药大学科学研究与创新基金重点项目(KCZD2018-3)。

摘　　要：目的 定量评价针刺联合甲氨蝶呤治疗类风湿关节炎的疗效及安全性,以期减少药量和药不良反应,提高患者生活质量。方法 通过检索Web of Science、Pubmed、CNKI、Wanfang Date、VIP、CBM数据库自建库至2022年2月20日以来的针刺联用甲氨蝶呤治疗类风湿关节炎的RCT文献,经过相应纳排标准、筛选、质量评价、数据提取及Meta分析。结果 共纳入10项研究,共计757例患者,试验组381例,对照组376例。Meta分析结果显示针刺联合用药在总有效率(RR=0.81,P<0.000 01)、红细胞沉降率(MD=-6.32,P<0.000 01)、C反应蛋白(SMD=-0.82,P<0.000 01)、类风湿因子(SMD=-0.59,P<0.000 1)均优于对照组;针药合用的不良反应发生率也低于对照组(RR=2.85,P=0.11);文献方法学质量评分较低。结论 针刺联合甲氨蝶呤治疗类风湿关节炎有较好的疗效和安全性,但由于纳入文献质量较低,有待高质量临床RCT研究加以论证。Objective To quantitatively evaluate the efficacy and safety of acupuncture combined with methotrexate in the treatment of rheumatoid arthritis(RA),in order to reduce drug dosage and side effects and improve the quality of life of patients.Methods RCTs literature on acupuncture combined with methotrexate for RA since February 20,2022 were retrieved from Web of Science,Pubmed,CNKI,Wanfang Date,VIP and CBM databases,and corresponding inclusion criteria,screening,quality evaluation,data extraction and Meta-analysis were performed.Results A total of 757 patients were included in 10 studies,including 381 in experimental group and 376 in control group.Meta-analysis showed that the total effective rate(RR=0.81,P<0.00001),erythrocyte sedimentation rate(MD=-6.32,P<0.00001),C-reactive protein(SMD=-0.82,P<0.00001)and rheumatoid factor(SMD=-0.59,P<0.0001)were better than those of the control group.The incidence of adverse reaction was lower than that of control group(RR=2.85,P=0.11).The quality score of literature methodology was low.Conclusion Acupuncture combined with methotrexate has good efficacy and safety in the treatment of RA,but due to the low quality of the included literature,the high-quality clinical RCTs need to be demonstrated.

关 键 词：类风湿关节炎 针刺 甲氨蝶呤 META分析 

分 类 号：R593.22[医药卫生—内科学]