含独活的中药复方治疗类风湿关节炎的网状Meta分析  

Network Meta-Analysis of Traditional Chinese Medicine Compound with Radix Angelicae Biseratae in the Treatment of Rheumatoid Arthritis

作　　者：任鹏飞 刘铭 文武龙 张炜烨 杨婧[2] 王锐[1] REN Pengfei;LIU Ming;WEN Wulong;ZHANG Weiye;YANG Jing;WANG Rui(College of Pharmacy,Heilongjiang University of Chinese Medicine,Harbin 150040,China;Basic Medical College of Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学药学院,哈尔滨150040 [2]黑龙江中医药大学基础医学院,哈尔滨150040

出　　处：《中国医院用药评价与分析》2025年第3期325-332,338,共9页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金资助项目(No.82074271)。

摘　　要：目的:基于网状Meta分析,评价痹痛康颗粒/丸、补肾汤、独活寄生汤等6种含独活的中药复方治疗类风湿关节炎的有效性和安全性。方法:进行文献检索(时间范围为各数据库建库至2023年11月23日),收集含独活的中药复方治疗类风湿关节炎的随机对照试验(RCT,对照组采用常规西药治疗,观察组在对照组的基础上联合应用1种含独活的中药复方),采用Cochrane偏倚风险评估工具对所得的RCT进行质量评估,使用RevMan 5.3软件进行文献管理和质量评价,使用Stata 17.0软件对所筛选的文献进行基于频率学框架的网状Meta分析。结果:共纳入38篇RCT文献,涉及总样本量为3446例,包括观察组1735例和对照组1711例。根据累积排序概率曲线下面积,在改善临床有效率方面,痹痛康颗粒/丸+常规西药为最有效的干预措施;在减少类风湿因子方面,补肾汤+常规西药为最有效的干预措施;在改善血清红细胞沉降率方面,独活寄生汤+常规西药为最有效的干预措施;在改善C反应蛋白方面,三痹汤+常规西药为最有效的干预措施。结论:含独活的中药复方与常规西药联合治疗类风湿关节炎患者,可以降低不良反应,并且治疗效果优于单纯使用常规西药。但由于缺少各药物之间的直接对比,且纳入文献总体质量偏低,纳入文献数量和病例数有限,上述结论仍需进一步验证。OBJECTIVE:To evaluate the efficacy and safety of six kinds of traditional Chinese medicine compound with Bitongkang granules/pills,Bushen decoction and Duhuo Jisheng decoction in the treatment of rheumatoid arthritis based on network Meta-analysis.METHODS:Literature(the retrieval time was from the establishment of the database to Nov.23rd,2023)were retrieved to collect the randomized controlled trials(RCT)of traditional Chinese medicine compound with Radix angelicae biseratae in the treatment of rheumatoid arthritis(the control group was treated with conventional Western medicine,while the observation group received one traditional Chinese medicine compound with Radix angelicae biseratae on the basis of the control group).Cochrane bias risk assessment tool was used to evaluate the quality of RCT,and RevMan 5.3 was used for literature management and quality evaluation.Stata 17.0 software was used to conduct a network Meta-analysis based on the frequency framework of the selected literature.RESULTS:A total of 38 RCT were enrolled,with a total sample size of 3446 cases,including 1735 cases in the observation group and 1711 cases in the control group.According to the area under the cumulative ranking probability curve,Bitongkang granules/pills+conventional Western medicine was the most effective intervention to improve the clinical efficiency;in terms of reducing rheumatoid factors,Bushen decoction+conventional Western medicine were the most effective intervention measures;in terms of improving serum erythrocyte sedimentation rate,Duhuo Jisheng decoction+conventional Western medicine were the most effective intervention measures;in terms of improving C-reactive protein,Sanbi decoction+conventional Western medicine was the most effective intervention measures.CONCLUSIONS:Traditional Chinese medicine compound with Radix angelicae biseratae combined with conventional Western medicine in the treatment of rheumatoid arthritis can reduce the adverse drug reactions of patients and the therapeutic effect is better than that

关 键 词：独活 类风湿关节炎 联合治疗 网状Meta分析 

分 类 号：R932[医药卫生—生药学]