中药外用治疗下肢丹毒的系统评价与Meta分析  

A Systematic Assessment and Meta-analysis of Topical Treatment of Erysipelas of Lower Extremity with Traditional Chinese Medicine

作　　者：李靖华 冯聆鹤 徐孟娇 张凡帆[2] LI Jing-hua;FENG Ling-he;XU Meng-jiao;ZHANG Fan-fan(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100029

出　　处：《云南中医中药杂志》2023年第10期18-26,共9页Yunnan Journal of Traditional Chinese Medicine and Materia Medica

基　　金：北京中医药大学2019年度基本科研业务费青年教师项目(2019-JYB-JS-150);北京中医药大学东方医院“1166”人才项目(040204001001002030)。

摘　　要：目的系统评价中药外用治疗下肢丹毒的有效性及安全性。方法纳入中药外用治疗下肢丹毒的临床随机对照试验。对中国知网、维普数据库、中国生物医学文献数据库、万方数据库等中文数据库及PubMed、Embase、Medline和Cocharne Library等外文数据库进行系统检索,检索时间自建库起,截止至2021年12月31日,结局指标包括治愈率、治愈时间、复发率、白细胞计数、C反应蛋白等。应用Cochrane方法学组发布的偏倚风险评价工具进行质量评价,应用R语言中的“Meta”包对结局指标进行Meta分析。结果共纳入18项研究,1159例患者,均来自中国,整体方法学质量偏低。Meta分析结果显示,中药外用治疗下肢丹毒,治愈率优于单纯抗感染治疗[RR=1.57,95%CI(1.40,1.77),P<0.001],同时能够缩短治愈时间[MD=-2.11,95%CI(-3.13,-1.08),P<0.001]、降低复发率、促进白细胞计数恢复[MD=-0.37,95%CI(-0.51,-0.23),P<0.001]。结论中药外用可提高下肢丹毒患者治愈率、缩短治愈时间、降低复发率、促进白细胞计数恢复,证据质量较低,主要由于随机过程的高偏倚风险而降级,有待高质量循证研究及安全性评价进行确证与补充。Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine in the treatment of erysipelas of lower extremity.Methods:Randomized controlled clinical trials were included in the treatment of lower extremity erysipelas with Chinese medicine.The systematic search on Chinese databases such as CNKI,VIP Database,China Biomedical Literature Database,Wanfang Database and foreign databases such as PubMed,Embase,Medline and Cocharne Library were conducted,starting from self-established databases and ending on December 31,2021.Outcome indexes included cure rate,cure time,recurrence rate,white blood cell count,C-reactive protein,etc.The bias risk assessment tool published by the Cochrane Methodology Group was used for quality assessment,and the Meta package in R language was used for meta-analysis of outcome indexes.Results:A total of 18 studies with 1159 patients were included,all from China,and the overall methodological quality was low.The results of the meta-analysis showed that the cure rate of topical treatment of lower extremity erysipelas was better than that of anti-infective treatment alone[R R=1.57,95%CI(1.40,1.77),P<0.001],and the cure time was shortened[MD=-2.11,95%CI(-3.13,-1.08).P<0.001],the recurrence rate decreased and the recovery of white blood cell count promoted[MD=-0.37,95%CI(-0.51,-0.23),P<0.001].Conclusion:The topical treatment of traditional Chinese medicine can improve the cure rate,shorten the cure time,reduce the recurrence rate,and promote the recovery of white blood cell count in patients with lower extremity erysipelas.However,the quality of evidence is lower,mainly due to the high risk of bias in random process,which needs to be confirmed and supplemented by high-quality evidence-based studies and safety evaluation.

关 键 词：下肢丹毒 中药外用 系统评价 

分 类 号：R753.5[医药卫生—皮肤病学与性病学]