雷公藤多苷联合糖皮质激素治疗甲状腺相关性眼病疗效的Meta分析

A meta-analysis of clinical efficacy of tripterygium wilfordii polyglycoside plus glucocorticoids on thyroid-associated ophthalmopathy

目的:系统评价雷公藤多苷联合糖皮质激素治疗甲状腺相关性眼病(Thyroid-associated Ophthalopathy,TAO)的有效性及安全性。方法:通过中国知网、维普、万方及外文数据库Pub Med检索从建库至2021年5月的文献,查找雷公藤多苷联合糖皮质激素治疗TAO的随机对照试验。对纳入的文献进行数据提取及方法学质量评价,采用Revman 5.3软件进行Meta分析。结果:共纳入14项RCTs,共1128例受试者。Meta分析结果显示两组总有效率[OR=4.98,95%CI(3.58,6.93),P<0.00001]、突眼度[MD=-3.61,95%CI(-4.13,-3.09),P<0.00001]、生活质量[MD=20.34,95%CI(17.30,23.38),P<0.00001]、不良反应[OR=0.21,95%CI(0.08,0.57),P=0.007]的差异有统计学意义,临床活动性评分(Clinical Activity Score,CAS)[MD=-0.50,95%CI(-1.51,0.51),P=0.33]的差异无统计学意义。结论:雷公藤多苷联合糖皮质激素能进一步提高TAO临床总有效率、患者的生活质量,显著改善患者的突眼度,减少不良反应发生,安全性好。

Objective:To systematically evaluate the clinical efficacy and safety of tripterygium wilfordii polyglycoside plus glucocorticoids on TAO.Methods:The literature from database establishment to May 2021 in CNKI,VIP,Wanfang Data and PubMed databases were searched by computer.The RCTs of tripterygium wilfordii polyglycoside plus glucocorticoids on TAO were retrieved.Data extraction and methodological quality evaluation of the included studies were conducted,and the Meta-analysis was performed by RevMan 5.3 software.Results:Fourteen RCTs studies with a total of 1128 subjects were included.The results of the Meta-analysis showed that there were statistically significant difference in the total efficiency[OR=4.98,95%CI(3.58,6.93),P<0.00001],the ocular protrusion[MD=-3.61,95%CI(-4.13,-3.09),P<0.00001],the quality of life[MD=20.34,95%CI(17.30,23.38),P<0.00001],and adverse reactions[OR=0.21,95%CI(0.08,0.57),P=0.007].There was no statistically significant difference in CAS scores between two groups[MD=-0.50,95%CI(-1.51,-0.51),P=0.33].Conclusion:Tripterygium wilfordii polyglycoside plus glucocorticoids on TAO can further improve the total efficiency and patients’quality of life,significantly ameliorate ocular protrusion,and reduce adverse reactions,and it is safety.