中药汤剂联合西药治疗类风湿关节炎的疗效:一项系统评价  

The efficacy of traditional Chinese medicine decoction combined with Western medicine on rheumatoid arthritis:A systematic review

作　　者：覃朗 凌丽丽 梁冰 苏振辉 岑梓曈 QIN Lang;LING Lili;LIANG Bing;SU Zhenhui;CEN Zitong

机构地区：[1]广西壮族自治区中医药研究院,广西南宁530022

出　　处：《中医临床研究》2024年第15期73-78,共6页Clinical Journal Of Chinese Medicine

基　　金：广西壮族自治区中医药管理局自筹经费课题(GXZYX20210045)。

摘　　要：目的:系统评价中药汤剂联合西药对比单用西药治疗类风湿关节炎(Rheumatoid Arthritis,RA)的临床效果,为中药汤剂联合西药的临床合理应用提供依据。方法:检索中国知网、万方、维普、PubMed、EMbase、Cochrane Library 6个数据库,根据纳入及排除标准,应用RevMan 5.4软件将文献录入,对纳入的每篇文献的结局指标进行荟萃分析。结果:共纳入15篇文献,结果显示:联合用药方面,中药汤剂联合西药比单独使用西药对减少RA晨僵时间[均数差(MD)=1.92,95%置信区间(CI)[1.16,2.68],P<0.00001)]、关节压痛数(MD=1.40,95%CI[0.74,2.05],P<0.00001)、关节肿胀数(MD=1.50,95%CI[1.08,1.92],P<0.00001)、关节疼痛数(MD=1.45,95%CI[1.04,1.86],P<0.00001)具有显著优势。结论:现有临床证据表明,中药汤剂联合西药对RA患者临床症状的改善优于单独使用西药。但目前研究仍以小样本研究为主,文献质量偏低,希望今后研究设计出更多高质量、严谨的随机对照试验(Randomized Controlled Trial,RCT),尽可能确保研究的真实性、临床实践性,发现更多临床效果显著的中西医结合治疗方法,从中获得相关经验以更好的指导临床。Objective:To systematically evaluate the clinical effect of TCM decoction combined with Western medicine in the treatment of rheumatoid arthritis(RA)compared with Western medicine alone,so as to provide evidence for the clinical rational application of TCM decoction combined with Western medicine.Methods:CNKI,Wanfang,VIP,PubMed,EMbase and Cochrane Library were systematically searched to retrieve the relevant literature.According to inclusion and exclusion criteria,RevMan 5.4 software was applied to input the data of the included literature,and the outcome indicators of each included literature were analyzed.Results:A total of 15 studies were included,and the results showed:Compared with Western medicine alone,TCM decoction combined with Western medicine reduced the morning stiffness time of RA(MD=1.92,95%CI[1.16,2.68],P<0.00001),the number of joint tenderness(MD=1.40,95%CI[0.74,2.05],P<0.00001),the number of joint swelling(MD=1.50,95%CI[1.08,1.92],P<0.00001),the number of joint pain(MD=1.45,95%CI[1.04,1.86],P<0.00001),which had a significant advantage.Conclusion:The existing clinical evidence shows that TCM decoction combined with Western medicine is better than Western medicine alone in relieving the clinical symptoms of RA patients.However,the current research still mainly focuses on small sample studies,and the literature quality is relatively low.It is hoped that more high-quality and rigorous RCT can be designed in the future studies,so as to ensure the authenticity and clinical practicability of the studies as much as possible,and more methods with obvious clinical effect can be found,from which relevant experience can be gained to better guide the clinical practice.

关 键 词：中药汤剂 西药 类风湿关节炎 疗效 系统评价 

分 类 号：R274[医药卫生—中医骨伤科学]